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The perception of an in shape and well toned body is that of muscular definition of which the abdomen is always a focus. Having a well cut abdominal wall, known as six-pack abs, is a desirous physical trait. While diet and exercise is the traditional method for obtaining that look, for some it is not always achievable despite this effort. For others they would rather take a less strenuous effort to achieve this abdominal look.

What is the six-pack abdominal look anatomically? It is enhancing the rectus musculature by seeing the lines of non-muscular fascial attachments. This includes the midline linea alba, the linea semilunaris and the several levels of horizontal inscriptions. In a person who achieve it naturally this occurs because the overlying subcutaneous fat layer is very thin and the muscle bulges outward from these attachments.

In the May 2019 issue of Plastic and Reconstructive Surgery an article was published entitled ‘Abdominal Etching: Surgical Technique and Outcomes.’ In this paper the authors review their experience with fifty (50) consecutive patients. Their technique consists of six (6) incisions, one at the umbilicus , three at the lower abdominal crease at the linea alba and semilunaris lines and two at the horizontal lines. (a bent cannula has not replaced the need for the lateral incisions) Power-assisted liposuction is used with running the cannula on the underside of the dermis between two fingers. Incisions are left open to drain and foam dressings are applied with an overlying abdominal binder for compression.

The average age of the patients were 36 years old with a near even distribution of mean and women. The patient satisfaction rate was 98% with no major complications. Minor complications occurred in 22% of the patients which were contour irregularities. Seromas occurred in 10% of the patients and resolved by traditional management methods.

This study shows that abdominal etching can be safely and effectively performed. One of the interesting aspects of abdominal etching liposuction is that it runs counter to some traditional liposuction principles. It is performed using a linear removal of fat from a vert specific line and removes such fat from the underside of the dermis. This is what is required in this very unique form of ‘linear liposuction’.

Dr. Barry Eppley

Indianapolis, Indiana

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