Buffalo Hump

A “buffalo hump” is a buildup of adipose tissue (body fat) at the base of the back of your neck and between your shoulder blades. But healthcare providers don’t use that term anymore. The medical term for it is dorsocervical fat pad hypertrophy. The buildup of adipose tissue causes your shoulders to develop a rounded or hump-like shape.

Seeing a hump on your back when you look in the mirror may make you self-conscious. It may also develop alongside other physical symptoms. If you’re concerned about the way you look or your health, reach out to a healthcare provider.

What causes a buffalo hump?

The most common cause of buffalo hump is having too much cortisol in your body, known as Cushing syndrome. Cortisol is a steroid hormone your adrenal glands make. Having too much cortisol makes your body form more adipose (fat) tissue than usual. This often leads to excess fat in specific areas of your body, like your face, the back of your neck and your belly.

Excess cortisol can happen due to:

• Increased production by your adrenal glands
• Long-term use of excessive doses of corticosteroids (often used to treat asthma, emphysema and many other conditions)

Excess cortisol typically causes other symptoms, like diabetes, high blood pressure, poor wound healing and purple stretch marks on your belly. If you have these symptoms, it’s important to see a healthcare provider. Cushing syndrome requires medical treatment.

Other causes

Other non-cortisol causes of buffalo hump include:

• Antiretroviral therapy (ART) to manage HIV
• Familial partial lipodystrophy, an abnormal distribution of fat tissue that’s genetic
• Madelung’s disease, a rare condition that causes abnormal fat deposits
• Central obesity that affects your face, the back of your neck and abdomen

If you’re self-conscious about having a buffalo hump or notice other related symptoms, reach out to a provider. They can help find the cause and offer solutions.

How can I get rid of a buffalo hump?

The treatment for a buffalo hump depends on the underlying cause. If a medical condition (like Cushing syndrome) is the cause, you’ll need treatment for that condition. You’ll likely need to see a hormone specialist called an endocrinologist for tests and treatment.

If a medication is causing a buffalo hump, your provider may recommend tapering (gradually reducing) the medication or switching to a different one. Never stop taking a prescription medication unless your provider says to do so.

If I lose weight, will my buffalo hump go away?

Maybe. If obesity is the cause of the buffalo hump, losing weight may help. But you can’t control where you lose body fat when you’re in a calorie deficit. If you have a condition or take a medication that causes your body to store fat tissue at the base of your neck, losing weight might not help.

It’s a good idea to talk to your healthcare provider to see if weight loss could help the appearance of the excessive fat deposit. If not, they can suggest other treatments.

Surgery

Rarely, if a buffalo hump is affecting your physical or mental health, surgery may be an option. Excisional lipectomy (fat removal) and liposuction are the two main surgical options for treating a buffalo hump. Liposuction is more common. 

A plastic surgeon does these procedures. Look for a board-certified surgeon with specialized training and plenty of experience.

It’s important to note that not everyone is a candidate for these procedures. Your healthcare provider will let you know if it’s an option for you.

What are the possible complications of not treating a buffalo hump?

In most cases, a buffalo hump doesn’t harm your physical health. But a severe buffalo hump can cause:

• Neck pain
• Nerve compression, which can cause numbness and pain
• Poor posture when lying on your back (supine posture)
• Sleep disturbances

See a healthcare provider if you’re having these symptoms. It’s also important to get help if a buffalo hump is affecting your self-esteem.

When should I see a healthcare provider?

If you develop a buffalo hump and have other symptoms of Cushing syndrome, it’s important to see a healthcare provider. If the hump is causing you emotional distress, you should also reach out to a provider. Your mental health is just as important as your physical health.

What’s the difference between a buffalo hump and a dowager’s hump?

A buffalo hump is the appearance of a lump at the base of the back of your neck due to excess body fat in that area. A dowager’s hump is a condition in which the spine in your upper back curves outward more than it should. The medical name for a Dowager’s hump is kyphosis.

These two conditions can be easy to confuse because they look and feel similar to the touch. The body fat in a buffalo hump is harder and denser than other kinds of body fat. You may think it’s your spine when you feel it.