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Background: A well shaped and toned abdomen is a goal of both men and women of all ages alike. While some have it naturally, particularly at a young age, most have to work to maintain or create it through some regular diet and exercise.  A trim waistline and a flat abdomen is a reasonable and attainable goal for many people and would make most happy. But there are a few others that have more loftier desires for their abdominal shape, an abdomen that has visually evident muscular outlines.

The so-called six pack or eight pack abdomen is one that has a midline vertical linea alba between the rectus muscles as well as their horizontal inscription lines evident. These are most commonly seen in young teenage boys and dedicated athletes and body builders. The one common denominator that they share is a very low percentage of body fat which results in such a thin subcutaneous layer of fat that the outlines of the abdominal muscles are seen.

But some patients, usually men, desire to have a well defined abdomen even if they can not create it by a low percentage of body fat and exercise. The artificial approach to creating this abdominal effect is known as abdominal etching or six pack abdominal surgery. This is a unique form of liposuction that removes a linear layer of fat over the vertical and horizontal muscle lines. This allows the overlying skin to indent inward along the lines of fat removal creating the muscle outlines rather than the muscle enlarging to achieve it.

Case Study: This 52 year male has lost fifty pounds and had gotten himself into a much improved shape through his own efforts of better eating and exercise. While he had made major improvements with a near flat abdomen and better waistline, he wanted to improve his abdominal result even further through a surgical approach.

Abdominal Etching Basket Cannula Dr Barry Eppley IndianapolisAbdominal Etching dressing intraop front view Dr Barry Eppley IndianapolisPrior to surgery he had markings made for the vertical midline and the vertical outer borders of the rectus muscles as well as the three paired horizontal inscription lines. Under general anesthesia, a 4mm basket cannula on a powered-assisted liposuction device was used to aggressively remove fat along all linear markings through small incisions. At the completion of the procedure linear strips of foam were placed along the etch lines and covered with a compression garment.

LW Abdominal Etching result front viewLW Abdominal Etching result oblique viewLW Abdominal Etching result side viewAt six weeks after the procedure his abdominal etch lines were becoming apparent as the skin contracts down to the reduced linear subcutaneous fat layers. Further definition in the abdominal etch lines would be expected to continue to develop up to three months after the procedure.

Middle Aged Male Abdominal Etching results Dr Barry Eppley IndianapolisAbdominal etching is a linear liposuction technique that does something liposuction is normally not intended to do…remove fat to deliberate create a focused skin indentation. Abdominal etching works best and looks the most natural in those patients who are already thin with a low percentage of total body fat.

Highlights:

  1. Abdominal etching strives to create the midline linea alba and the horizontal inscription lines of the abdominal muscles.
  2. Abdominal etching is a specialized form of liposuction that uses a linear line of maximal fat removal to create its effect.
  3. The best results in abdominal etching come from those who have a thinner subcutaneous fat layer over their abdomen.

Dr. Barry Eppley

Indianapolis, Indiana

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