Ultra HD Liposuction: Enhancing Abdominal Etching Using Ultrasound-Guided Rectus Abdominis Fat Transfer (UGRAFT)

High-definition (HD) liposuction has allowed surgeons to sculpt the abdomen, enhancing abdominal etching. To create a more athletic abdomen, fat grafting has been used subcutaneously, and rectus abdominis fat grafting has been performed in patients undergoing lipoabdominoplasty. With the objective of increasing muscle volume to obtain a natural-looking abdomen in patients who are not suitable for abdominoplasty, we propose the use of ultrasound-guided rectus abdominis fat grafting (UGRAFT) in association with HD liposuction.

A prospective study with 10 consecutive patients undergoing UGRAFT was conducted. After HD liposuction, UGRAFT was performed from an incision in the umbilical region, using a blunt 2.5-mm cannula assisted by ultrasound. Fat injection was done closer to the anterior rectus sheath in the lower and middle muscle bellies.

UGRAFT was performed in 10 patients. The mean age was 34.8 years (range, 24-51 years). The mean body mass index was 23.83 kg/m² (range, 20.58-28.39 kg/m²). The mean volume of fat injected per "pack" was 34 cm³ (range, 20-40 cm³). UGRAFT added a mean time of 20 minutes (range, 15-30 minutes) to HD liposuction. Comparing the rectus abdominis muscle thickness pre-UGRAFT and post-UGRAFT, average muscle thickness increase was 5.1 mm (55.7% ± 37%), with P < 0.0001.

UGRAFT showed to be helpful for obtaining muscle expansion and a more natural abdominal contour, avoiding that unnatural appearance that HD liposuction may provide in patients who gain weight or have skin laxity.