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Background <p>Dorsocervical fibro-lipodystrophy, commonly known as “buffalo hump,” presents a challenging deformity often associated with HIV-related lipodystrophy or idiopathic etiologies. Although various surgical techniques have been reported, a comprehensive evaluation of their safety, efficacy, and recurrence rates remains lacking. This systematic review and meta-analysis aimed to evaluate outcomes of surgical interventions, particularly suction-assisted lipectomy, in managing dorsocervical fibro-lipodystrophy.</p> Methods <p>A systematic review with meta-analysis was conducted using PubMed and ScienceDirect. Eligible studies reported surgical outcomes of dorsocervical fibro-lipodystrophy managed with suction-assisted or excisional lipectomy. Meta-analyses used a random-effects model, with heterogeneity and publication bias assessed. Sensitivity analysis was performed.</p> Results <p>Twenty-two studies encompassing 218 patients were included. Most cases were associated with HIV-related lipodystrophy, and the average patient age was 47.4&#xa0;years. Suction-assisted lipectomy was the most common approach. The pooled recurrence rate with liposuction was 10.6%, and revision procedures occurred in 15.3% of cases. Following sensitivity analysis, recurrence and revision rates decreased to 1.4% and 1.3%, respectively, with minimal heterogeneity. The pooled recurrence rate after excisional lipectomy and hybrid techniques was 0%. Reported complications included seroma, hematoma, wound dehiscence, and bacteremia, with higher rates observed in excisional or hybrid approaches. Methodological quality varied, with most studies scoring moderately.</p> Conclusion <p>Suction-assisted lipectomy appears to be a safe and effective treatment for dorsocervical fibro-lipodystrophy, especially when performed with meticulous technique. However, the overall low quality of evidence underscores the need for prospective studies to optimize management strategies.</p> Level of Evidence III <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>

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Surgical Management of Dorsocervical Fibro-Lipodystrophy (Buffalo Hump): Systematic Review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2026年5月4日

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  • Joseph M. Escandón,
  • Chihiro Matsui,
  • Gabriel De La Cruz Ku,
  • Lauren Escandón,
  • Pedro Ciudad,
  • Oscar J. Manrique

摘要

Background

Dorsocervical fibro-lipodystrophy, commonly known as “buffalo hump,” presents a challenging deformity often associated with HIV-related lipodystrophy or idiopathic etiologies. Although various surgical techniques have been reported, a comprehensive evaluation of their safety, efficacy, and recurrence rates remains lacking. This systematic review and meta-analysis aimed to evaluate outcomes of surgical interventions, particularly suction-assisted lipectomy, in managing dorsocervical fibro-lipodystrophy.

Methods

A systematic review with meta-analysis was conducted using PubMed and ScienceDirect. Eligible studies reported surgical outcomes of dorsocervical fibro-lipodystrophy managed with suction-assisted or excisional lipectomy. Meta-analyses used a random-effects model, with heterogeneity and publication bias assessed. Sensitivity analysis was performed.

Results

Twenty-two studies encompassing 218 patients were included. Most cases were associated with HIV-related lipodystrophy, and the average patient age was 47.4 years. Suction-assisted lipectomy was the most common approach. The pooled recurrence rate with liposuction was 10.6%, and revision procedures occurred in 15.3% of cases. Following sensitivity analysis, recurrence and revision rates decreased to 1.4% and 1.3%, respectively, with minimal heterogeneity. The pooled recurrence rate after excisional lipectomy and hybrid techniques was 0%. Reported complications included seroma, hematoma, wound dehiscence, and bacteremia, with higher rates observed in excisional or hybrid approaches. Methodological quality varied, with most studies scoring moderately.

Conclusion

Suction-assisted lipectomy appears to be a safe and effective treatment for dorsocervical fibro-lipodystrophy, especially when performed with meticulous technique. However, the overall low quality of evidence underscores the need for prospective studies to optimize management strategies.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.