Madelung's disease (Md) is a rare metabolic disorder which presents with multiple symmetrical nonencapsulated fatty masses situated mainly around the head, neck and nape. The main indications for Md treatment are: shortness of breath, head's movement restrictions, swallowing disorders (dysphagia), aesthetic considerations, and the fear of cancer. The standard treatment of Md is the surgical excision of pathological tissues. The disease is progressive, relapses after removal of tissue are often observed. The discussion is based on a three-year observation of Md patient operated by the authors. A good cosmetic result and symptoms subsidence were observed. There were no sings of disease recurrence.