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Utilizing the Power of Fat Grafting to Obtain a Naturally-Appearing Muscular "6-Pack" Abdomen.

Liposuction of the male abdomen can be a very challenging. If undertreated, any of several techniques can leave a less than satisfying result showing little if any improvement. With more aggressive generalized suction of the area, the patient can be left with irregularities, loose residual lower, and excess infraumbilical soft tissue and skin.

In the modern age of fitness, we find that patients are increasingly interested in a fitter, more sculpted look with greater definition to the abdominal musculature. Currently we are experiencing a “golden age” of plastic surgery body contouring with new innovations by thought leaders, including fat grafting, which are completely raising the bar of postoperative results that can now be delivered to the patients in terms of appearing youthful and sculpted yet natural.1 Previous techniques involving abdominal contour including selective fat reduction or “sculpting” have been limited in terms of inability to achieve muscular appearance in patients with very little muscular bulk to the rectus abdominis.2,3 Furthermore, abdominal muscle enhancement with silicone has been equally disappointing due visible incisions, an unnatural appearance, technical difficultly, lack of implant availability, and increased infection rate. Here we present the senior author's (D.S.S) technique for achieving superior results in abdominal contouring using selective lipo-contouring with fat grafting.

The technique may be used with general anesthesia, local anesthesia with sedation, or simply local anesthesia. All markings are done with the patient standing prior to any sedative administration. Anatomic asymmetry is noted.

The patient is brought in the operating room placed in the supine position after circumferential betadine prep. Stab incisions are made after injection of 2% lidocaine with epinephrine and tumescent solution (0.9% saline with lidocaine 0.1% and epinephrine 1:1,100,000) is introduced into the areas to be suctioned. Three stab incisions are made in the underwear line to …