Madelung's disease, also known as benign symmetric lipomatosis (BSL), is a rare condition characterized by symmetric, painless fatty deposits arranged around the neck and shoulders girdle. This deformity is usually associated with chronic alcohol. The etiology remains unclear although some authors suggest that mitochondrial dysfunction represents the essential biochemical defect in BSL. This report describes a patient with this deformity. Lipomas were present in the pre-postauricular and nuchal area.