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Abdominal etching is a well known liposuction technique that is used primarily in male torso contouring. What was once used to shape and contour the abdomen in male body builders is now more widely used for  leaner males who desire what their own workout routinues can not give them. It is not a shaping technique for  more rounder and fuller abdomens where more generalized liposuction is first needed. Some may call abdominal etching a ‘cheater’s approach’ to a ‘six-pack abdomen’, but it does work in properly selected patients nonetheless.

Abdominal etching highlights the contours of the rectus muscle through linear liposuction of fat at very specific levels. These levels potentially relate to three vertical and three horizontal levels. These are the tendinous portions of the paired rectus muscles which are the vertical midline linea alba and the paired lateral linea semilunaris, and horizontal inscriptions which occur on both sides symmetrically at three level above the belly button.. Patients with adequately developed musculature chose full abdominal etching to get a complete ‘six pack.’ Patients who are not as generously  contoured to begin with are better off with less abdominal detail, known as modified etching, which only contours the linea alba and semilunaris.

Abdominal etching is done with small liposuction cannula that are used to remove as much fat as possible between the underside of the skin and these tendinous levels, creating an indentation or groove. This is not how liposuction is typically done where some fat needs to be left so that the skin does not stick down to the muscle. But this is exactly what you are trying to achieve with  etching.

In most cases, you can get good ‘six-pack’ detail with traditional liposuction cannula. It is not as impressive as what one sees on a professional body builder (who has little to no abdominal fat) but it is still quite distinct. But in other cases, I have seen indentations that were not as well defined or as symmetric as I thought while making them. Recently, in my Indianapolis plastic surgery practice, I have used the laser probe from Smartlipo to do abdominal etching. The probe is narrow and is ideally suited to make these grooves. The heat from the laser helps remove or melt more fat that might otherwise be left behind from liposuction aspiration alone. Plus, heating up the underside of the skin over the groove may encourage it to shrink and scar down to the muscle. The results have been very encouraging and I believe this is an improved method for more consistent results in abdominal etching.

Dr. Barry Eppley

Indianapolis, Indiana

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