Buffalo hump is a manifestation of HIV related lipodistrophy, it is characterized by an enlargment of dorsocervical fat pad and is distressing for patients. Surgical correction until a few years ago was the only option for treatment, however in last years non surgical corrections was carried out with minimally invasive techniques. Authors report this case that describe a longer follow up of an already published study were this deformity was treated with the injection of an adipocitolitic aqueous micro-gelatinous solution and during all the follow up no relapse was observed.