Can Abdominal and Pectoral Etching Be Done At The Same Time As Abdominal Liposuction and Gynecomastia Reduction?
Q: Dr. Eppley, I’ve been seeing a lot of stuff online regarding abdominal and pectoral etching that brings out the corresponding muscles. Is this something you can do along with the liposuction/gynecomastia procedure I am undergoing? Thanks.
A: Pectoral and abdominal liposculpture (to be differentiated from volumetric liposuction reduction) are fine cannula liposuction techniques that can be done as a stand alone procedure or combined with overall chest and abdominal liposuction. They are designed to try and highlight the natural underlying musculature which everyone has. In the abdomen it is known as etching where linear liposuction is done along the linea alba vertically and horizontally along the tendinous inscription lines to hopefully create more of a six- or eight-pack look. In the chest, the lateral pectoral triangle is aggressively reduced along the lateral pectoral muscle border up into the axilla as well as fat injections done into the lower pectoral muscle border hopefully creating a more defined pectoral outline. The success of these manuevers is highly dependent on the patient’s natural fat anatomy and work best in individuals that are already somewhat thinner.
What done as a stand alone procedure in already thin patients who do not require much volume reduction, they produce the best results. When done as part of an overall gynecomastia and abdominal reduction in someone who is not heavy or grossly overweight (you) usually modest definition is achieved. In heavier patients or patients with thicker abdominal fat and fuller gynecomastia problems, these are not good techniques as the results will simply not be very visible.
In short, these liposculpture techniques can be applied at the time of your gynecomastia and abdomninal liposuction procedure. They add a little more time to the procedure as they involve etching manuevers after the gross fat removal is done. They key about them is that patients need to have realistic expectations as how visible the muscular outlines will be and that it usually takes up to 3 months to see the fine details of the result.
Dr. Barry Eppley
Q: Dr. Eppley, I’m emailing to consult on your ability to improve some concerns that has not been ameliorated through exercise and diet. I am 5’10 and weight 172 pounds. Specifically, my upper cheeks and face carry a significant amount of fat which appears to be genetic and gives my face a chubby look. I have attached pictures and circled the areas of my concern. In addition, I’m curious what you can do for the fat in my chest and underarm area. A number of military guys I have spoken with have mentioned a procedure known as “pectoral etching”. What it sounds like is liposuction in this area with some contouring to create a more defined/chiseled pectoral look.
A: What you are demonstrating in your pictures is a zone of cheek and perioral subcutaneous fat, a layer that lies just under the skin. It should not be confused with deeper fat layers, such as the buccal fat pad, which it is not. These are very difficult areas to successfully reduce although its treatment is straightforward. Small cannula liposuction is used from a small incision inside the mouth and the bottom end of the nasolabial fold. In my experience I have seen good and mediocre results with this procedure. The hardest area to improve is that closest to the eye. The other issue with facial liposuction in this area is some prolonged swelling. While this is very typical of liposuction anywhere, it is very visibly noticeable when it is in the middle of your face.
From a chest standpoint, you are correct about pectoral etching. There is nothing magical about this technique. It is the artistic use of liposuction to create a better pectoral definition, largely using reduction of the lateral pectoral triangle for its effect. I have used it frequently with overall chest liposuction in male gynecomastia liposuction surgery.
Dr. Barry Eppley