Men are lining up for 'ab-etching.' A cosmetic surgeon says she has to steer some clients away.
Perfectly chiseled abs require investment, whether it's a strict routine of strength training, cardio, and diet — orab-etching.
Ab-etching is liposuction that targets the abdominal region, removing some fat to make the muscles more pronounced.
For clients with deeper layers of fat, "you shape the fat to look like a six pack or to look more muscular," Dr. Giselle Prado-Wright, a cosmetic surgeon and the co-owner of Exert BodySculpt in Villas, Florida, told Business Insider.
She said it's more common in her clients in their 30s to 50s who gain fat in their mid-section and want a little more definition as they age. As more men request cosmetic procedures such as penis enlargement and hair restoration, ab-etching has taken off in her office, she added.
How it works
Ab-etching was invented in the early 1990s by Dr. Henry Mentz, a Houston-based plastic surgeon. However, it took time for the technique to gain traction.
By the early 2000s, other plastic surgeons, like Dr. Alfredo Hoyos in Colombia, enhanced and popularized the technique. Hoyos became famous for high-definition liposculpture, where he would highlight desired muscles rather than simply remove fat.
More recently, ab-etching became one of the most popular cosmetic procedures among men during the pandemic plastic surgery boom, Prado-Wright said.
It's not clear exactly what drove this trend into turbocharge, but Prado-Wright thinks a lot of guys who come into her clinic ended up spending more time on social media during lockdowns, and started to obsess over having six-packs.
While Prado-Wright sometimes recommends ab-etching to lean, toned women, "men are the ones that go out of their way to ask for it," she said — even if they're not the best candidates for it.
The procedure is no simple fix, though. It's one of the most involved surgeries you can undergo, Prado-Wright said.
Regular liposuction involves suctioning the fat from specific areas of the body to achieve a more toned look. The nerve endings near the abdominal muscles are more sensitive than in other parts of the body, making ab-etching a more painful form of liposuction.
Like all forms of lipo, recovery involves wearing a compression garment for about six weeks and abstaining from the gym for at least two to three weeks, Prado-Wright said.
To maintain results, she said, you need to stick to an ab-defining lifestyle. If an ab-etching client remains consistent with his diet and gym routine, he will likely "look fantastic until the day he dies," Prado-Wright said.
Even with its potentially long-lasting effects, ab-etching is expensive. Prado-Wright said she usually charges $7,000-$9,000.
In cities like New York, ab-etching can cost up to $13,000.
Social media six-packs
The best candidate for ab-etching is someone who's already "very close" to having abs, Prado-Wright said. They work out a lot and have a thin layer of body fat.
She said men in their 50s with bodybuilding backgrounds who tend to hold fat in their abdomens benefit from ab-etching. "You just softly define their existing abdominal muscles, and they look really, really good."
However, she said she's often fielding men who don't work out much or who fluctuate more in weight. Some men, who don't have big ab muscles, ask for fat injections into their six-pack squares to make them bulge more.
"If they gain weight, it looks weird," she said. "Some of them, you've got to steer them to something else."
Ab-etching is the tip of the iceberg
Cosmetic procedures are on the rise among men. Prado-Wright said male clients often bring in photos from other surgeons, like Hoyos, the Colombian plastic surgeon who transformed ab-etching.
They also often ask for things like gynecomastia surgery (breast reduction) and penis filler, she said, the latter of which has exploded in popularity in her office in recent years.
Still, she said the popularity of the procedure means men are talking about it more, including when the results feel cartoonish.
"They're saying to me, 'My friend did it,'" she said. "'It doesn't look great in person, so I just want it to be softer.'"

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