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With Abdominal Etching, Plastic Surgeons Help Patients Get 'Six-Pack Abs'

Even with a good diet and workout routine, some men and women have trouble getting the toned abdominal appearance they want. For these patients, a technique called abdominal etching can help in creating the classic "six-pack abs" physique in men or three-vertical-line abdomen in women, reports a study in the April issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

The procedure uses precisely targeted liposuction to achieve greater definition of the abdominal muscles, according to the paper by Tarik M. Husain, MD, FACS, of University of Miami Leonard M. Miller School of Medicine and colleagues. "Abdominal etching using power-assisted liposuction is a novel method of sculpting an ideal abdomen," Dr. Husain comments. "Our study shows that this is a safe and effective method to create a defined anterior abdominal wall in both male and female patients."

Emerging Liposuction Technique Produces Abdominal 'Six-Pack'

The researchers review their experience with liposuction to improve the appearance of the abdomen in 50 patients: 26 men and 24 women, average age 36 years. Patients seeking abdominal etching were in good shape, with a healthy diet and regular exercise routine, but had "certain resistant areas of fat" that made it difficult to achieve the abdominal muscle definition they desired.

Dr. Husain and coauthors outline the procedure in detail, starting with patient selection and preoperative markup. Following meticulous liposuction technique, the plastic surgeon sculpts the abdominal fat in both the superficial and deeper layers, accentuating the patient's natural "six-pack" lines in males and 3 vertical lines in females. Hip lines are usually desired by both sexes. The technique can be altered to provide a softer, shallower or a harder, more-defined degree of abdominal etching, depending on the patient's preference. The online version of the article on the Plastic and Reconstructive Surgery website includes a video illustrating key aspects of the procedure for plastic surgeons.

The authors spell out critical steps for postoperative care. Foam dressings are cut to size to compress the newly etched lines for at least three days. This is followed by full-time compression for two weeks postoperatively and two weeks part-time after that.

It is critical to have regular follow up early on to assess for any fluid collections, or seromas. To ensure good results, these seromas – typically regarded as a minor complication – need to be treated aggressively if they occur.

Patients can resume light exercise not engaging the core after two weeks, and more rigorous exercise after four weeks. The researchers stress the importance of maintaining good long-term results, with the assistance of a sports nutritionist and/or integrated medicine physician to optimize nutrition, exercise plan, and hormone imbalances. Patients have maintained good results of abdominal etching at follow-up times up to six years.

None of the 50 patients undergoing abdominal etching had major complications requiring hospitalization or return to the operating room. Minor complications occurred in 22 percent of patients, such as contour irregularities (usually "over-etching") that typically soften up and improve over time. Seromas developed in 10 percent of patients, and were promptly managed by a simple office procedure.

"The patients exemplify that the procedure can be performed with optimal aesthetic results, and minimal postoperative complications," Dr. Husain and coauthors conclude. They hope their technique and experience of abdominal etching will serve as a useful guide to other plastic surgeons who are interested in offering this relatively new procedure. The authors add, "We also highlight our extensive post-operative management, with the addition of a multidisciplinary nutrition and personal training team with the goal to maintain [patients'] long-term results and retain their newly etched abdominals."

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

Click here to read "Abdominal Etching: Surgical Technique and Outcomes"

Article: "Abdominal Etching: Surgical Technique and Outcomes" (doi: 10.1097/PRS.0000000000005486)

About Plastic and Reconstructive Surgery

For more than 70 years, Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.

About ASPS

The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 8,000 member surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 93 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery.

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