Buffalo Hump bulge
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Buffalo Hump bulge

A ‘Buffalo Hump Bulge’ is characterized by fat accumulation in the region of the back of the neck. This is due to the presence of high levels of cortisol, caused by a condition called Cushing Syndrome. Cortisol is a steroid hormone that regulates the metabolism and immune response of the body. High levels of the hormone can cause fat to accumulate around the shoulders leading to a hump on the back, near the neck. 

There are various reasons why a person would develop a buffalo hump neck. Some of it might be because of the body’s response to aging while others can be due to the side effects of medications. The patient might experience physical difficulties with a buffalo neck and it's important to get treated by a qualified doctor. We discuss some of the most common symptoms, causes, and treatments to reverse the condition. 


Other than a hump in the region of the shoulder blades, the below symptoms can be evident if one suffers from a buffalo hump bulge. 

  • Moon face - swollen and fluffy appearance of the face 
  • Thinning of hair - caused by the excess of androgen production in female patients 
  • Red cheeks 
  • Supraclavicular fat pad - fat accumulation around the neck and shoulder regions 
  • Increased body and facial hair 
  • Weight gain 
  • Pendulous abdomen - hanging of the abdomen towards the pelvic region caused by unfirm abdominal muscles 
  • Thin extremities with muscle atrophy 
  • Purple striae 
  • Slow wound healing 
  • Ecchymosis/discoloration of the skin caused by bruising 
  • Thin skin and subcutaneous tissue 
  • Elevated blood sugar, hypertension, irregular menstrual cycle, osteoporosis, and depression 


  • High levels of cortisol or steroid hormone 

Individuals with medical conditions such as pituitary tumors, lung tumors, and more can develop more adrenocorticotropic hormones that can increase the level of cortisol in the body

  • Long term use of glucocorticoid medications 

Individuals with autoimmune conditions, heart diseases, strokes, inflammation, skin conditions and more are prescribed glucocorticoid medications. 

  • Chronic stress 

Individuals could experience acute stress (which lasts for a short period of time), chronic stress (ongoing stress/anxiety), and traumatic stress (caused by traumatic experiences) 

  • HIV infections 

Medicines such as antiretroviral drugs that are used in the treatment of HIV infections can also be a reason for buffalo hump

  • Madelung disease 

The medical condition can cause unusual lipid storage in different parts of the body. An individual with Madelung disease can expect fat deposition in various parts such as arms, neck, back, hips, and thighs. 

  • Obesity

Excess fat due to obesity can also lead to buffalo hump. 

  • Osteoporosis 

In some cases, weakened bones caused by osteoporosis can also be a reason for the development of buffalo hump bulges. 

  • Chronic sleep issues  

Individuals with sleep issues can develop buffalo bluge. Insomnia, sleep apnea, and working night shifts can all contribute to increased cortisol production in the body. 


In some cases, the buffalo hump bulge might go away by identifying the root cause and treating it accordingly. If the buffalo hump is the result of obesity, sleep apnea, or osteoporosis, treating the condition can give relief from the bulge. It is important to consult the right general physician or cosmetic surgeon to diagnose the causes and take the required treatment. 

  • Diet and lifestyle changes 

If the buffalo hump bulge is caused due to obesity, switching to a healthy diet and lifestyle is quintessential. Reducing weight would help reverse the bulge. In cases where the medications have led to the bulge, it is important to discuss with the doctor for alternate medications. Including a diet that is low in sugar, salt and fat is important. One must include more of fiber and proteins in the diet by increasing the intake of whole grains, vegetables, fruits and lean meat. If the buffalo hump neck is caused by osteoporosis, one must ensure a diet that promotes bone health. Foods rich in calcium and vitamin D are important. This could come from mushrooms, eggs, milk, fish, soybeans, nuts, and vegetables such as cabbage, spinach, lady’s fingers, and others. Exercises such as chin tucks, neck stretches, standing push-ups, and shoulder blade squeeze can also help reduce the bulge. 

  • Surgical removal 

If the hump does not seem to be reducing with the diet, exercise or non-surgical interventions, then surgery is done to remove the excess fat and the hump. This can be a permanent solution for removing the buffalo hump bulge. The pros and cons of surgical removal should be discussed with a board-certified cosmetic surgeon. If the patient has preexisting health conditions, surgery should be done only after the doctor finds no possible risks or complications. 

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