Q: I am interested in getting a six-pack look to my stomach. I work out all the time and do a lot of abdominal crunches but it is just not appearing. I am a man who is fairly lean and have only 9% body fat at 34 years of age. I have read about a liposuction method called ‘etching’ which can make the six-pack look in one surgery. Can you tell me how it is done and what makes it work? Are there any long-term problems with having it done?
A: The abdominal etching surgery to which you refer is a modified liposuction method for producing abdominal highlights. Using fine liposuction cannulas, fat is removed along predetermined highlight lines in a linear array of a central vertical line and multiple (usually three) horizontal lines. By removing linear lines of fat lines, this causes the stomach skin to selectively indent inward which then appears like the underlying abdominal muscles lines, creating the ‘six-pack’ look. Interestingly, abdominal etching is done in exactly the opposite way that traditional liposuction is done. Rather than trying to remove an even amount of fat over a broad surface area of the abdomen to avoid any irregularities, etching deliberately aims to create indentations through an uneven (but precise) amount of fat removal. Abdominal etching is really best done on someone who already has a near flat abdomen and wishes for a more liposculpture approach rather than a large amount of fat removal. It is not a good idea for someone who has a large protuberant abdomen or is significantly overweight. The only long-term issue is what would happen if you gain abdominal weight. The etch lines may look peculiar on a bigger belly.
Dr. Barry Eppley