**4.3 Abdominal etching**

Candidates for abdominal etching include patients who desire muscular definition in addition to fat reduction.

Patients with poorly defined muscular anatomy are candidates for modified abdominal etching, while patients with well-defined muscular anatomy are candidates for full abdominal etching [50].

Modified abdominal etching involves moderate fat preservation over the rectus abdominis muscles with thinning of the subcutaneous fat layer over the external obliques. Increased definition is performed at the linea alba and linea semilunaris.

Full abdominal etching adds liposuction of the rectus muscle inscriptions to the areas of liposuction performed in modified abdominal etching.

## **4.4 Drain vs. No drain**

Incisions are either left open for drainage or closed with simple interrupted sutures when small volume liposuction is performed. Drain placement is considered for larger areas of liposuction. A 7 mm flat JP drain is placed to facilitate fluid egress and seroma prevention when larger volume liposuction is performed. The lumbar (hip roll) area is often drained especially in the setting of concomitant abdominoplasty. In these cases, the liposuction cannula can be advanced through the subcutaneous tissue from one liposuction entry site to another, the external portion of the drain is placed over the cannula and the drain is pulled through the entry site. When Renuvion is performed, the access sites are left open to allow for helium gas and fluid escape.
