Abdominal Etching: Past and Present

Since its inception in the 1980s, liposuction has undergone a tremendous paradigm shift from the simple removal of excess subcutaneous fat to a procedure of extreme sophistication and elegance where we as surgeons are able to mold and shape a patient's figure. Plastic surgeons have modified this procedure with the overall goal of improving the aesthetic results while focusing on maximizing safety and minimizing complications. These modifications include advanced liposuction technology and techniques, the increasing use of subdermal superficial liposuction, differential liposuction, the advent and introduction of a wide range of cannulas, and the use of fat grafting simultaneously with liposuction for targeted contour and fat repositioning. In this article, the authors discuss in detail the introduction and progression of abdominal etching, a procedure first introduced by the senior author (H.A.M.) in the early 1990s. The authors also present their experience over the past 4 years. In this procedure, the technique of differential liposuction is employed to enhance the detail of abdominal musculature. The literature on abdominal etching is fairly scarce. Thus, the authors hope that this review will not only give the provider a thorough review and understanding of liposuction and its evolution over the years but will also provide an overview of the indications, patient selection, technique, expectations, and complications of abdominal etching as well.