Although a photo or physical exam would better determine what procedure would be amenable to soften the appearance of a buffalo hump, your two options would be liposuction or excision. Liposuction often suffices since there is little skin laxity in this region. If this area had been previously treated with liposuction and recurred, or if there is discernable mass that can be felt, then direct excision may be option.
Liposuction is the suction removal of subcutaneous fat. Subcutaneous fat is located just below the surface of the skin and above the muscles and bones. It doesn't remove all of the fat, but it does remove the majority of the fat. The perfect candidate is at or near their ideal body weight and has localized areas of fat that are out of proportion to the rest of the body. It is not a weight reduction technique. It can be used on any area of the body, but it relies on the skin redraping after the fat is removed. So, if you have loose skin, you may end up with wrinkles or folds after the surgery. Some areas respond better to liposuction than others, the lateral thighs always look nice, the inner thighs and arms, not so much. The tummy depends on how loose the skin was to begin with. It does not remove or improve stretch marks. There are many different terms used for liposuction:Tumescent liposuctionPower liposuctionLaser liposuctionVaser liposuctionSmart liposuctionUltrasonic liposuctionAnd many, many more. All these techniques vary a little, but the bottom line is that the fat is removed by high powered suction. A small tube or cannula with multiple holes at the end is hooked to a suction device. The cannula is moved rapidly back and forth to remove the fat through very small incisions in the skin. All blood vessels, nerves, muscle, bone and skin is left alone, just the fat is removed. Large amounts of fluid are placed in the subcutaneous fat before the suction begins to reduce bleeding and to numb the skin, this fluid is referred to as tumescent fluid and consists of a balanced salt solution mixed with adrenalin and a local anesthetic. There are 3 choices of anesthesia:Local anesthesia (the patient is awake)Local with sedation (the patient is given a mild sedation)General anesthetic (the patient is asleep)The choice is based upon an agreement between the patient and the surgeon. Make sure you consult with a Board Certified Plastic Surgeon who operates in a nationally accredited surgery center and offers board certified anesthesia. If the price you are quoted seems abnormally low, please do your research and find out why, you do not want to be surprised the day of your surgery!Liposuction can be combined with many other procedures; tummy tuck, breast reduction, thigh lift, arm lift, neck lift and is an essential part of a Brazilian Butt lift (this is where the fat comes from!) All of my patients are treated post operatively with a compression garment that is worn for 2 weeks and 5 Endermologie sessions that start 3-4 weeks after the procedure. Endermologie is a non surgical massage technique that helps to smooth out the results of the surgery to help prevent wrinkling and rippling of the skin.Liposuction is not a very painful procedure and recovery is usually quick. Most people are back to work in 3-5 days and back to vigorous exercise in 2 weeks. Of course, if more areas are treated, there will be more pain post operatively and a longer recovery. I was back to work 3 days after my abdominal liposuction and no one knew any better!The cost varies not only from city to city, but from patient to patient. The more areas that are treated, the higher the cost. In the midwest, typical liposuction prices varies from $3,000-6,000 total.Based on the information presented I would recommend the following:liposuction of the buffalo hump, it actually works quite well in this area!Good Luck!
