Many people dream about having washboard abs, but some never seem to be able to achieve that look, no matter how much they exercise. If you are one of those people, you may wish to consider abdominal etching.
Abdominal etching is a surgical procedure designed to sculpt the much sought-after ideal abdomen. This procedure – which has been in use since the 1990s – is a specialized type of liposuction, specially designed for highlighting and accentuating the abdominal musculature.
Ab etching vs. liposuction
The main difference between traditional liposuction and abdominal etching is the extent to which fat is removed. Liposuction generally removes subcutaneous fat from many different areas of the body (thighs, buttocks, love handles, etc) and is not intended to give patients a “six pack” appearance. Whereas abdominal etching, involves a much more precise technique to remove localized fat specifically from the abdomen to create the definition of “six pack” abs.
Abdominal etching is meant for individuals who already have a good diet and exercise regimen, and have well-developed abdominal muscles. Many people are never quite able to achieve that “washboard abs” appearance, no matter how much they work at it. Abdominal etching helps these people to finally achieve the well-defined look they seek. As well, some individuals who undergo abdominal liposuction or a tummy tuck will go on to have abdominal etching in order to further enhance their new appearance.
You might be a good candidate for abdominal etching if you are:
- In good overall health, with no major medical issues
- A non-smoker
- Less than 20-30% over your ideal body weight
- Physically fit and have an athletic build
- Already have well-toned abdominal muscles, with only a thin layer or small pockets of stubborn fat that cover the muscles
- With healthy skin tone and elasticity.
You might not be a candidate if you are:
- Unable to tolerate an anesthetic
- Overweight with a significant amount of weight to lose from the abdomen
- With a body fat percentage greater than 18%
- Unrealistic about your expectations.
Those wishing to undergo abdominal etching should understand that after surgery, a healthy diet and exercise regimen is essential for maintaining the results.
How is the procedure done?
Abdominal etching is an outpatient procedure using either local or general anesthesia. The entire procedure usually lasts no longer than one hour and begins with a consultation from a board-certified plastic surgeon.
On the day of the procedure the following steps typically take place:
- In preparation, the surgeon will mark out the areas that are being enhanced or sculpted. The surgeon will check with you to make sure you are satisfied with the plan. These markings will serve as guides during the surgery.
- A special type of foam pressure dressing is placed on the skin above the areas where the liposuction will be performed. The foam remains in place for one week after the surgery.
- Anesthesia is administered
- Next, several small incisions will be made in the belly button or following natural creases on the abdomen.
- Then, a small metal tube known as a cannula will be inserted underneath the skin. In some cases, surgeons might use different size cannulas to assist with more precise fat removal.
- Using various types of liposuction (e.g Ultrasound, Laser, etc) excess fat is removed along the lines drawn by the surgeon, sculpting the abs into the desired contours.
- At the end of the procedure, most patients do not require sutures since the incisions usually measure less than a quarter of an inch long.
Is abdominal etching safe?
Any surgery has potential risks involved, but abdominal etching is considered a low-risk elective procedure with a high level of patient satisfaction. In fact, a review of 512 male abdominal etching cases found only 3 patients needing corrective surgeries.
Some potential complications may include:
- Adverse reactions to anesthesia
- Excessive scarring internally or in the skin where etching took place
- Infection after the surgery (usually occurring in first 3-5 weeks)
- Contour defects requiring revision
- Nerve damage or permanent loss of skin sensitivity, particularly around the belly button
- Seroma (fluid collection under the skin)
- Skin necrosis (skin that loses its blood supply and dies), scarring, irregular healing after the surgery
- Thromboembolic event (dangerous venous blood clots)
- Fat embolism (fat that enters the bloodstream)
- Accidental surgical entry into the abdominal cavity
- Skin hyperpigmentation (darkening).
Before the procedure, your plastic surgeon will review in detail all potential complications with you prior to surgery. Be sure to discuss these potential risks and complications with your surgeon before moving forward with your treatment.
How long will recovery take?
You can go home the same day as the surgery. A binder (tension wrapping) will be placed over the foam pressure dressing before you are discharged. Most individuals return to work in 1-2 weeks.
After surgery, you can expect to experience some pain and discomfort, which should be manageable using over-the-counter pain medications. You can expect some swelling, bruising, and redness around the surgical site.
The foam pressure dressing will remain in place for one week. You can shower with it on, but you must remove the binder, and the foam should be dried with a towel or blow dryer prior to replacing the binder. The binder is worn for 4-6 weeks, full-time for the first two weeks, then part-time after that.
When will I see results?
Most of the post-operative swelling resolves in the first two weeks, but the final aesthetic appearance continues to improve gradually over the course of 3-6 months.
According to a 2019 study of 50 people who had abdominal etching, 98 percent of participants were satisfied with the results 27 months after the procedure.
Exercise after surgery
Light exercise is permitted after two weeks, but heavy exercise and running should not be started until four weeks post-operatively. People are encouraged to maintain fitness after the surgery to maintain the results, and some surgeons involve dieticians and personal trainers in aftercare
Cost of abdominal etching
The total cost of an abdominal etching procedure includes the surgeon’s fees and the costs of anesthesia and the surgical facility. The average cost of abdominal etching is around $4,500 to $8,000.
The price varies widely based on the liposuction technique — that is, whether you opt for laser lipo, tumescent liposuction or another method of fat extraction. Often, people combine it with liposuction on another body part such as the hips or thighs; having several liposuction procedures performed at once can be less expensive than having them done individually.
In general, the cost of your procedure will depend on the geographical location, the surgeon selected, the amount of fat removed, and the exact liposuction technique used.
Are there non-surgical alternatives?
Currently, there are not any non-surgical treatments that can achieve the same degree of results as abdominal etching surgery. However, there are some options for those who desire a less invasive procedure that helps reduce small pockets of unwanted fat or build muscle.
- CoolSculpting: a non-surgical technology that freezes away unwanted fat. CoolSculpting aims specifically at fat cells beneath the surface of the skin, targeting them in a safe and effective way.
- Emsculpt: a non-invasive FDA approved body contouring treatment to simultaneously build muscle and burn fat. On treatment with this device is equal to 20,000 sit-ups.
- American Society of Plastic Surgeons (ASPS). (2019, April 22). With abdominal etching, plastic surgeons help patients get 'six-pack abs'. ScienceDaily. Retrieved from www.sciencedaily.com/releases/2019/04/190422155008.htm
- American Society of Plastic Surgeons (ASPS). (2019). Plastic surgery statistics report. Retrieved from https://www.plasticsurgery.org/documents/News/Statistics/2019/plastic-surgery-statistics-full-report-2019.pdf
- Guerra, A. (2007). Abdominal etching: Clinical and technical measures for achieving predictable outcomes. American Society of Plastic Surgeons Annual Conference Proceedings. 2007. Retrieved from https://asps.confex.com/asps/2007am/techprogram/paper_13159.htm
- Khanna, A., & Filobbos, G. (2013). Avoiding unfavourable outcomes in liposuction. Indian Journal of Plastic Surgery, 46(2), 393–400. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901920/
- Hoyos, A.E., & Perez, M.E. (2020). Invited discussion on: Post-operative complications and patient satisfaction after abdominal etching—prospective case series of 25 patients. Aesthetic Plastic Surgery 44, 836–838. https://link.springer.com/article/10.1007%2Fs00266-020-01646-w
- Husain, T.M., Salgado, C.J., Mundra, L.S., Perez, C., AlQattan, H.T., Bustillo, E., et al. (2019). Plastic & Reconstructive Surgery, 143(4), 1051-1060. Retrieved from https://www.researchgate.net/profile/Erik_Bustillo/publication/332127608_Abdominal_Etching_Surgical_Technique_and_Outcomes/links/5ce4b53f299bf14d95af53a8/Abdominal-Etching-Surgical-Technique-and-Outcomes.pdf
- Agochukwu-Nwubah, N., & Mentz, H. (2019). Abdominal etching: Past and present. Aesthetic Surgery Journal, 39(12), 1368-1377. https://academic.oup.com/asj/article/39/12/1368/5492334