The TABLE Technique: A Targeted Open Approach for Fibrous-dominant Dorsocervical Hump (Buffalo Hump).

Background: The TARD technique (Tumescent anesthesia, sharp cannula Release, Debulking) achieves satisfactory outcomes in mild-to-moderate fibrofatty dorsocervical hump, but shows limitations in fibrous-dominant subtype.

Objectives: To introduce a novel TABLE technique (Tumescent anesthesia, Border release and liposuction, Limited-open access, Extraction and excision) for fibrous-dominant dorsocervical hump and to evaluate the safety and efficacy of this procedure.

Methods: A retrospective analysis was conducted on 72 patients treated between January 2022 and December 2023. Patients with fibrous-dominant dorsocervical hump were treated using the TABLE approach. Outcomes included the surgeon-assessed contour improvement (4-point scale, evaluated by two independent plastic surgeons), patient-reported Neck Extension Mobility Score (NEMS) and complications. Follow-up was 12 months.

Results: The TABLE technique demonstrated satisfactory outcomes in fibrous-dominant cases, with 93% good-to-excellent outcomes (36% excellent, 57% good) based on two surgeons' evaluation. Excellent inter-rater reliability was confirmed (Cohen's κ = 0.71). Neck mobility improved, with NEMS decreased from 2.6 to 1.3, and the overall complication rate was 20.8%.

Conclusions: TABLE is a safe and effective minimally invasive solution for fibrous-dominant dorsocervical hump, achieving improved aesthetic and functional outcomes.