**5.4 Case 4: abdominal etching with VASER**

Case 4 is an example of full abdominal etching on a 44-year-old male. He also underwent chest contouring with VASER liposuction and gynecomastia gland excision. A total of 950 cc of fat was removed from the abdomen and chest (**Figure 6**).

### **5.5 Postoperative care**

All patients are placed in compression garments at the conclusion of the procedure. When combined with abdominoplasty, an abdominal binder is placed for ease of evaluating the abdominal flap postoperatively. For circumferential trunk liposuction, either an abdominal binder or compression garment is placed. A layer of foam is placed beneath the garment to ensure even compression and reduce indentations from the garment.

If the patient is staying overnight for monitoring, the drains are hooked up to wall suction to allow for rapid fluid egress and removal of residual tumescent fluid. The drains are placed back to bulb suction when the drainage slows down.

Patients are prescribed oral antibiotics, pain medication, and vitamins. Patients are instructed to drink plenty of fluids with a goal of 1 gallon per day. The abdominal binder or compression garment is worn at all times, except when

**Figure 4.**

*Preoperative photographs and markings. Patient shown 5 months postoperatively with excellent contour and skin contraction.*

showering, which is permitted on postoperative day 2. It is recommended that patients wear some form of compression for at least 6 weeks postoperatively. Drains are removed once the output is less than 25 cc per day for at least two consecutive days.

Three Endermologie® (LPG Endermologie USA, Fort Lauderdale, FL) treatments are recommended to all patients to improve postoperative edema, with the option to add further treatments for continued areas of swelling or firmness. The Endermologie machine employs a suction-assisted massage technique that improves lymphatic drainage [51].
