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Liposuction of the abdomen is the most common body contouring procedure done today. It has remained so since the introduction of liposuction techniques almost forty years ago. The primary objective of abdominal liposuction has been volume reduction, make the abdominal and flank areas smaller with a less thick fat layer.

While the term ‘liposculpture’ is often thrown around as if to imply it is a different and more sophisticated form of liposuction, most of the time when that term is used it is more of a marketing and promotion concept. In the purest sense of the word, liposculpture implies the objective of a liposuction-treated area to give it a specific form or shape. Size reduction alone does not really constitute ‘liposculpture’.

One very distinct type of liposculpture is that of ‘abdominal etching’. Rather than volume reduction it aims to create specific lines or indentations that mimic the underlying location of the fascial horizontal inscriptions and the vertical midline linea alba. Known as ‘six-pack abs’ it is best performed on already in shape patients who do not need high volume fat removal.

Abdominal etching is effective through the creation of distinct lines of subcutaneous fat removal to simulate externally what the muscular abdominal wall looks like internally. In an ideal result a dermal-fascial adhesion is created along the treated abdominal lines although this is not always needed to occur for visual success. To help ensure these adhesions happen and show maximal linear indentations, I apply narrow strips of foam along each line at the end of the procedure. This looks like a skeletal outline or a geometric pattern. An abdominal binder is applied over them as is commonly done in all abdominal liposuction cases.

These strips of foam stay on for 48 hours although the abdominal binder is used longer for patient comfort. It takes 6 to 8 weeks for the extent of the six-pack pattern to fully appear.

Dr. Barry Eppley

Indianapolis, Indiana

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