Liposuction and surgery

Removal of abdominal fat by liposuction is regarded as risky because liposuction is designed to remove fat under the skin, rather than the harder visceral fat which often develops with lipodystrophy. However, it appears to be an effective strategy against 'buffalo hump'.

Several groups have now reported on the use of liposuction and other surgical techniques to remove buffalo humps. Reports generally indicate favourable results in the short term; however, the humps often recur and complications of surgery, sometimes major (infections, anaemia and pancreatitis) are not uncommon.^{1 2}

Liposuction was compared to surgical fat removal by Italian investigators who performed liposuction in 15 patients and surgical fat removal in 3. As well as experiencing changes in their body shape, all the patients in the Italian case series suffered from restricted neck movement, abnormal posture, and back pain. Buffalo hump recurred in only one person, after liposuction, after an average post-surgery follow-up of 19 months. The relapse patient had received liposuction and was taking a regimen including d4T, 3TC and efavirenz. ²

This study favoured the use of liposuction over surgery. The disadvantages of surgical removal of fat included scarring, long operating time, a higher risk of post-operative complications and a long recovery time. By contrast liposuction was found to be simpler and more efficient, having the advantage of good hump correction, shorter operating time, less scarring, the risk of fewer complications, and quicker recovery.