What is six pack surgery or ab etching?

If you’re aiming to have six-pack abs, you can hit the gym religiously and stick to a strict, super-lean diet. But you may still struggle to achieve a chiseled physique. If so, abdominal etching surgery may help.

Ab etching is a form of liposuction that strategically removes fat around the abdominal muscles to create the “lines and shadows in the body that give one a toned, defined, athletic look,” explains Dr. Josef Hadeed, a plastic surgeon surgeon in Beverly Hills. California, and former chairman of the Patient Safety Committee of the American Society of Plastic Surgeons, or ASPS.

Liposuction overall has been the most popular cosmetic surgical procedure for years — and while most people who get lipo are women, it’s becoming increasingly common in men, according to ASPS. Ab etching is performed for both men and women, but Hadeed said he sees more men interested in it.

“One of the biggest reasons is they just want to feel good about themselves,” he said. “We hear from a lot of men: they go to the gym all the time. They eat well. They take care of themselves. They are just stubborn grease spots that they just can’t seem to get rid of no matter what they do.”

Some men say they want a “more youthful appearance” to maintain their career edge and look good with their shirt off at the beach or pool, Hadeed added. People are also just more aware of ab etching than in the past, he said, as it is often talked about on social media.

If a six-pack is your goal, plastic surgeons want you to know the following about ab etching, including the best candidates for the procedure and what results you can expect.

Ab etching is a form of high-definition liposuction; it differs from traditional lipo, which focuses solely on fat removal. Ab etching is more strategic, explained Dr. Lyle Leipziger, chief of plastic surgery at North Shore University Hospital and Long Island Jewish Medical Center in New York.

Surgeons mark a grid pattern on the abdominal wall and discuss the results you are trying to achieve. Then, fat is selectively removed from certain areas to make the muscles appear larger, Leipziger said. In some cases, fat can be injected into other areas to further improve the appearance of the muscles.

“It’s like peaks and valleys,” Leipziger said. “You want to preserve certain areas to create the appearance of a muscle bulge, and then you want to remove fat in other areas to create a valley between those areas so that the muscles look better.”

Ultimately, the goal is to create more muscle definition based on a person’s natural anatomy. “The same way you would chisel a sculpture out of a large piece of stone, that’s what we do with high-definition liposuction,” says Dr. Christopher Costa, the founder of Platinum Plastic Surgery in Las Vegas.

Ab etching can be done under general or local anesthesia, depending on the case. Costa said small incisions are made to insert liposuction devices, and the procedure can take two to three hours.

Some men get an ab etch if they just want to contour their abdomen, Hadeed said. But they often also want more definition on their chest, back, shoulders and arms, and they receive high-definition liposuction in those areas at the same time.

It’s all about ensuring a proportionate look, Hadeed said. “Anytime you do high-definition lipo, you want to make sure you’re addressing the body as a whole because you want the results to look as natural as possible.”

People who are already physically fit and have existing muscle tone are best suited for ab etching, said Dr. Jason Emer, a cosmetic dermatologic surgeon in Beverly Hills.

“They train all the time and look really good, but their bodies don’t show their abs and chest as defined,” he said. They may have loose skin, or their six-pack may be hidden under a layer of fat.

Ab etching is not considered weight loss surgery. Ideally, men should already be close to their ideal weight, Leipziger said. “We’re talking about people who diet, exercise, take good care of themselves and are generally healthy,” he noted.

This can help them maintain their six-pack results, which would be “worthless” if they were to skip the gym, forego a healthy diet or gain weight after healing from the procedure, Hadeed said.

According to a study published in 2019 in the journal Plastic and Reconstructive Surgery, ab etching is safe and effective, with patients experiencing an acceptable rate of complications and generally feeling satisfied with the procedure.

Still, it is elective and any surgery can come with risks, such as infection, bleeding or scarring, Leipziger said. In general oOther risks with liposuction include bruising, wavy or loose skin, irregularities and asymmetry, changes in skin sensation or pigmentation, and the need for revision surgery, according to ASPS.

Swelling is common after ab etching. Hadeed recommended lymphatic drainage massage, a type of gentle massage, for about a week after surgery, to get rid of excess fluid and reduce swelling. Sometimes patients wear drains to remove fluid.

Patients should also wear a compression bodysuit for about six weeks after the procedure, Hadeed said. This ensures that the skin conforms to the contours of the body and that everything heals properly.

Patients can usually return to work in about a week, Hadeed added, noting that they can resume light cardio after four weeks and weight lifting after six to eight weeks.

Because ab etching requires strategy and attention to detail, doctors say it’s crucial to find a board-certified plastic surgeon who has experience performing the procedure. Costa suggested getting two or three different consultations, reviewing each surgeon’s before-and-after photos, and making sure the doctors discuss the recovery process carefully.

Emer said he often performs revision surgeries on men who went to inexperienced doctors and got results that just don’t look good. For example, a man may have had six-pack surgery without any contouring of the chest or shoulders, meaning the overall look is off. Or their abs may look too feminine; Emer said some doctors have more experience performing surgeries on women, and suggested asking about their ab etching work on men before signing up.

Ab etching is intended to be a “one-time procedure,” Costa said.

It may take two or three months to fully heal and see the final results of the surgery, Leipziger said. Only oneas long as you follow your doctor’s postoperative instructions, keep training and maintain your weight, you can expect the results to be “quite long-lasting and permanent,” Hadeed noted.

However, weight gain can affect the contours of your abdominal muscles If you lose weight, you may develop loose skin – both of which will change the final look, Costa said.

You may need adjustments after a few years if you want “a super strict definition as time goes on,” Emer noted. People lose muscle mass and experience sagging of the skin with age, which can change how your abs look.

The most important thing, Leipziger emphasized, is to have realistic expectations and discuss them with your surgeon.

“It’s not a quick fix,” he says. “This procedure, if performed for the right reason on the right patient, can produce beautiful aesthetic results. But it is up to the patient to really maintain those results by maintaining a healthy lifestyle, diet and exercise.”