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Is There a Surgical Shortcut to Six-Pack Abs?

— A plastic surgeon weighs in on high-definition liposuction

MedpageToday
A photo of surgeons performing liposuction.

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Getting defined six-pack abs is no easy task, but there is a procedure that can give patients a boost in achieving the results they want.

High-definition liposuction or liposculpture, sometimes referred to as "ab etching," is a procedure that involves strategically removing fat from target areas and re-injecting it in other zones to create the illusion of muscle definition. This procedure is increasing in popularity, particularly among men, the American Society of Plastic Surgeons .

Neil Tanna, MD, a plastic surgeon and vice president of women's surgical services with the Katz Women's Surgical Center at Northwell Health in Great Neck, New York, told 鶹ý that while liposuction removes fat, high-definition liposuction goes a step further.

"You do liposuction in a way that accentuates the desirable contours of the body," he explained, noting that this is often the muscle contours of the abdomen.

For general liposuction, patients are first injected with tumescent fluid which contains epinephrine, a vasoconstrictor, as well as lidocaine, a local anesthetic, because liposuction can be painful.

"That way, when you're doing it there's less bleeding and bruising, less pain, and then that fluid is also helping you to suck and break up that fat," Tanna said. After waiting a bit, a cannula -- a thick metal rod with a hole on the end -- is used to "harvest" the fat.

High-definition liposuction is more selective about where the fat is removed from in order to carve out cavities. "You kind of create these negative spaces where you remove additional fat between pockets of muscle so you can accentuate that area," Tanna said.

Then comes fat grafting -- where the fat that's been removed is added into the muscle pockets to make the muscles look bigger than they actually are. This is similar to the process of the popular aesthetic procedure Brazilian butt lift (BBL) which involves a diffused fat transfer to the buttocks. The procedure only takes 1 to 3 hours and patients are fully recovered in a few days.

While high-definition liposuction is not as deadly as BBLs, there are significant risks -- like re-injected fat entering the bloodstream.

"When you're injecting fat, you have to make sure that it's getting into the correct places and where you don't want the fat to go is ... into the blood vessels, because that fat can then travel ... to undesirable places, like the heart or lungs," Tanna said. Other risks include skin and fat necrosis as well as intestinal perforation, which can occur if the cannula is inserted too deep and punctures an organ below -- often the colon.

in Aesthetic Plastic Surgery assessed the results and complications of high-definition liposculpture in 417 patients and found that while "non-serious complications were frequent, most complications were local and safely treated without affecting surgical outcome."

Two-thirds of patients had hyperpigmentation and about a quarter had seroma or nodular fibrosis. Other complications included unsatisfactory definition in superficial liposuction areas, an unnatural looking body contour, burns related to the procedure, and Mondor's syndrome. Still, patients were overwhelmingly satisfied with their results, the study showed.

Tanna emphasized the importance of candidate selection for high-definition liposuction. The ideal candidate should be at their ideal weight and able to maintain it because fluctuations in weight change how fat looks on the body and how the skin moves, so the results may not hold with too much change in weight, though Tanna noted this is understudied. Any elective surgery is still a major health decision, Tanna said.

He also noted that social media has contributed to the rise in this procedure since people are connected to more information about cosmetic procedures and wanting to present their image to the world a certain way. Ultimately, high-definition liposuction is not a miracle shortcut to six-pack abs, but it can give patients the final push to reach their aesthetic goals.

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    Rachael Robertson is a writer on the 鶹ý enterprise and investigative team, also covering OB/GYN news. Her print, data, and audio stories have appeared in Everyday Health, Gizmodo, the Bronx Times, and multiple podcasts.