When it comes to the ‘abs’ most people think of having a six-pack. And many work hard to try and get it. But not many can for a variety of reasons…not working hard enough, too much abdominal fat from poor diet and not the right body type. Getting six-pack abs really comes down to genetics and hard work.
Actually everyone already has a built-in six-pack, known as the abdominal inscriptions, which are part of the rectus abdominus muscles. The rectus abdominus muscles are a set of paired vertically oriented muscles that extend between the bottom of the rib cage and extend down into the pubic area. Throughout their vertical course, they are crossed by three fibrous bands called the tendinous inscriptions. They are usually three such horizontal crossings, one at the level of the belly button, one up high near the bottom of the rib cage below its central xiphoid process and a third one about halfway between the two.
These inscriptions cause indentations or lines across the muscle to appear as they extend about halfway into it. Regardless of your weight and abdominal size, everyone has these inscriptions. The trick is having a thin enough fat layer between them and the overlying skin for them to be seen on the outside.
For those who diet correctly, exercises regularly, and do a lot of abdominal work but can’t get the cut abdominal look they desire or others who just want to take a shortcut, there is a way. A plastic surgery procedure known as ‘abdominal etching’ or ‘six-pack’ surgery can create it. While often described as ultra-sophisticated liposuction, it is really a form of linear liposuction. Rather than removing fat over a broad surface, fat is removed along a very specific linear lines where the tendinous inscriptions lie. One vertical line is made down the center representing the linea alba between the rectus abdominus muscles through an incision inside the bellybutton. Then the horizontal lines are made from small tiny incisions placed in the middle from which the lines can be made out to the sides.
As much fat as possible is removed between the skin and the tendinous inscriptions to create permanent indentations in a six-pack fashion. While there is an artistic side to how much fat to remove and the location of the lines, it is a relatively simple technique of small cannula liposuction done along straight lines.
Like all liposuction, it takes months after surgery to see the final result as the underside of the skin contracts down to the muscle. Such lines will likely be permanent since the fat cells will not return to the indentation lines. However, the number of fat cells outside of the lines are greater in number and will get bigger should one gain weight. Thus abdominal weight gain may create an unnatural look after etching, creating the ‘waffle look’ with fat ballooning up between the lines. It behooves one to maintain a healthy lifestyle and exercise program afterwards.
The best candidates of abdominal etching are those men and women who are already fairly fit and lean. The thinner the abdominal fat layer the more the inscription lines will show.
Dr. Barry Eppley
Indianapolis, Indiana