Fat redistribution disorders are common complications of antiretroviral therapy. Corrective surgery is increasingly used to treat localized fat accumulations that are difficult to treat medically or by changes in drug regimens, but is limited by relapses caused by the continuation of antiretroviral therapy. The surgical treatment of buffalo hump has a long-term favourable effect in the majority of patients continuing antiretroviral therapy, and can therefore be considered in patients experiencing considerable physical or psychological discomfort.