Which lipo to go with for a buffalo hump? NYC (Photo)

Question

The more doctor I see the more confused I become. :-( so here are my questions? 1. Traditional or laser assisted lipo?? One says laser causes hyperpigmentation the other swears; for small areas they never use laser only traditional. 2. What are the chances to end up with loose skin or/and lumps, irregularities of the skin after lipo of the Buffalo hump 3. Fat is very dense, fibrous in this area, will traditional lipo be able to break down the fat? Thank you for taking the time!

John K. Wakelin III, MD, FACS · Answer

All liposuction techniques can be very effective for addressing your buffalo hump.  From what your pictures show there appears to be little chance of having loose skin after the procedure.  Laser assisted liposuction, ultrasound assisted liposuction and traditional liposuction can all be very effective for this area.  What is most important is your surgeon's experience and expertise with treating this area, as it can be challenging to achieve an optimal result, since the fat in this area is often dense.  The good news is that the success rate is very high with the proper approach.  I recommend that you discuss this with a board-certified Plastic Surgeon who performs multiple different techniques to help you determine with option is best for you.  Best of luck to you!

Pedy Ganchi, MD · Answer

Hello,The buffalo hump can be effectively treated with traditional tumescent liposuction under local anesthesia and the skin typically retracts well. An experienced Plastic Surgeon is all you need!Warm regards,Dr. Pedy Ganchi                                                                                                         Village Plastic Surgery

Robert M. Tornambe, MD · Answer

imuzone I appreciate your frustration and confusion, however buffalo hump is not that unusual and I have treated many of these cases quite successfully with traditional liposuction only. Even though the fat in this region is fairly fibrous, it is easily broken down with traditional liposuction and then suctioned away. That area on the back re-drapes nicely and I have never had issues with loose skin or irregularities.  Come see me or another board-certified plastic surgeon in the area to increase your chances of the best possible result. Good luck.

Christopher L. Hess, MD · Answer

Fat at the base of the posterior neck/upper back is often referred to as a buffalo hump.  Many times this fat collection is actually a large lipoma or benign fatty tumor.  As such it can have a capsule which if not removed could cause the lipoma to reoccur.  Excision or removal would be the best way to remove it but this would leave an unsightly scar. Laser and ultrasonic liposuction both heat and melt the fat which is then sucked out.  Traditional liposuction mechanically removes the fat.  Any of the techniques used correctly will work fine and without complications.  The skin of the back is very tight and will contract without leaving excess skin.

Richard Wellington Swift, MD · Answer

Thank you for posting your photo with your interesting question. Your buffalo hump can be safely liposuctioned with either technique so long as the plastic surgeon has experience with the procedure. You are looking for a result, not necessarily a technique. The buffalo hump has fat and fibrous tissue inside. I use a combination of special  techniques to deliver the best results, which I have successfully done many times. The back skin is very thick and elastic and will most certainly contract for you. I recommend that you have a consultation with a Board Certified Plastic Surgeon who is highly experienced with liposuction. At the time of your consultation, you will have an examination of the buffalo hump, discuss your goals, have al of your questions answered to your satisfaction and see many of the plastic surgeon's before and after buffalo hump liposuction case photos. Best wishes, Richard Wellington Swift, M.D.

Arnold S. Breitbart, MD, FACS · Answer

I have had excellent results using SmartLipo to treat buffalo hump and have not seen hyperpigmentation.  SmartLipo liposuction has the advantage of first treating the fat with the laser to soften and liquefy the fat so it then suctions out more evenly and completely.

Kenneth R. Francis, MD, FACS · Answer

Dear Imuzone,Either technique of liposuction will be effective in reducing your dorsal neck hump.  With your fair skin hyperpigmentation is an extremely remote possibility.  You should expect an excellent result.  Good luck!

Douglas Taranow, DO, FACOS · Answer

Thanks for the question.You will never get a single answer...there are none.  All types of liposuction work, and each is good for multiple areas.  The buffalo hump is very fibrous and requires experience and technique to obtain great results.  Whether you use traditional, laser or ultrasonic liposuction, as long as your surgeon is proficient at liposuction, you will have a good results.Go for several more consultations to make your final decision.Best of luck.Dr T

Robert L. Kraft, MD, FACS · Answer

Can be treated with traditional liposuction only.  You should understand that this is not an absolute treatment and the hump can regrow.  That is why insurance will only pay for formal excision and not removal by liposuction due to the recurrence rate.  I do not view laser as a necessary adjuvant for this procedure. Best wishes.

Mats Hagstrom, MD (license on probation) · Answer

Buffalo hump liposuction is very straightforward. You can stop worrying about any of the issues you've brought up so far. The only thing that can and will make a major difference is who does the procedure.  A good plastic surgeon can get you a perfect outcome with any liposuction  equipment. If a laser cost hyperpigmentation then why would anyone use it? Perhaps the doctor saying they don't use laser for small cases is planning on doing this in his office and he does not own a laser. Perhaps larger cases are done at the local surgery center and they may perhaps own a laser. Most likely this is salesmanship 101. There is some connective tissue in the fat in this area but not enough that any liposuction equipment cannot get the job done. Personally I really like working with microaire PAL or power assisted liposuction. Pick the right surgeon and everything will fall into place.  You will not have uneven contours or loose skin. Pick the wrong provider and any of the above can happen. Look for providers that appear ethical have a minimum of five or 10 years experience since they finish their training. Do they have large social media campaigns that are paid for?  The most talented plastic surgeons I know do not pay for advertising and do not focus a lot of their energy on social media. They still use traditional word-of-mouth reputation and they are busy. Best, Mats Hagstrom M.D.

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