Abdominal Etching (HD Lipo)

Abdominal etching is typically well-tolerated, and during the procedure, you won’t feel any discomfort, but mild to moderate soreness, swelling, and tightness are common in the first few days of recovery. Most patients compare the sensation to an intense core workout, with tenderness around the sculpted areas. Dr. Rivera provides prescription pain medication and post-op care instructions to ensure a safe and comfortable recovery. By the end of the first week, discomfort is significantly reduced, and most patients can resume light activities.

The abdominal etching process involves two key appointments: the initial consultation and the surgery itself. A pre-operative appointment is also recommended but not necessary. During the consultation, Dr. Rivera will assess your body composition, muscle definition, and fat distribution to create a customized surgical plan. A pre-operative visit may also be scheduled to review preparation guidelines, answer final questions, and ensure you’re fully ready for the procedure. After the surgery, you’ll have follow-up appointments at one week, one month, and three months to monitor healing and ensure optimal results.

While you’ll notice immediate contour changes after the procedure, the final results take time to develop fully. Swelling typically peaks within the first week and gradually subsides over the next four to six weeks. By the three-month mark, the definition becomes much more apparent, and your midsection will appear leaner, tighter, and more sculpted. Once all swelling has resolved, full results are typically visible within six months. To maintain long-lasting results, patients should follow a healthy lifestyle with proper diet and exercise.

It is common to pair this procedure with traditional liposuction, body lifts, or a tummy tuck to enhance the abdominal area further. Chest or arm liposuction procedures can also help create a more sculpted and balanced physique. If you’re considering multiple treatments, Dr. Rivera will customize a surgical plan to achieve your goals while ensuring a safe and smooth recovery. Combining procedures may also reduce overall downtime compared to undergoing separate surgeries.

Abdominal etching carries some risks, including swelling, bruising, and temporary numbness in the treated area. If the healing process does not go as expected, contour irregularities may occur, though Dr. Rivera’s technique minimizes this risk. In rare cases, complications such as infection, fluid accumulation (seroma), or asymmetry may occur. During your consultation, Dr. Rivera will thoroughly discuss all potential concerns and how to properly care for your body during recovery for the best possible results.

Rivera Plastic Surgery offers the only “Full Tech” liposuction service in Miami and South Florida. By “Full Tech”™, we describe our practice approach that offers all the State-of-the-Art technologies for liposuction and body contouring, including the ones used in Colombia, where Dr. Rivera has learned many of his techniques used in his practice in Miami

A “Full Tech”™ liposuction or body contouring case involves using most of the following technologies during the actual liposuction:

• Vaser® ultrasound for fat separation
• Microaire®  Power Assisted Liposuction (PAL) for fat extraction
• For skin tightening (one of he options below, depending on the case):
  • Radiofrequency with Retraction® SmartLipo device
  • Radiofrequency with Renuvion®  J Plasma® device
  • Radiofrequency with BodyTite® or QuantumRF® devices
  • Laser SmartLipo device
• Awake Liposuction (if the patient prefers it over general anesthesia)

In addition, Dr Rivera-Serrano is an expert in Awake liposuction, which is performed without general anesthesia and may even involve skin removal (a “tummy tuck alternative”).

High Definition (HD), 3D, or 4D Liposuction

The concept of High-densition lidocus (or abdominal etching) was developed in Colombia and South America. The idea behind the concept is to liposuction some areas more than others to highlight the muscular anatomy and create the illusion of a more athletic body. Dr. Rivera applies the high-definition concept to every single liposuction case as he believes everyone will benefit from some degree of definition. The definition can be soft or subtle, moderate, or athletic.

It is very important to understand that liposuction is not a weight loss solution or a diet and exercise replacement. In fact, people often weigh more in the first weeks after liposuction than before surgery due to water retention. Any weight loss thereafter is not very significant compared to before surgery. A good diet and exercise regimen are fundamental post-operatively for a good and long-lasting result. If good diet regimens are not followed, the results will not last, and you are better off not having surgery. After liposuction, a compression garment is temporarily used to help the skin contract, decrease swelling and recovery time, and decrease the chances of seromas (collections of fluid).

Local Anesthesia = NO NEED for General Anesthesia

The procedure can be carried out under local anesthesia; the patient is usually awake but sedated. Dr. Rivera-Serrano has vast experience in this field. Not many surgeons have experience with major liposuction under local anesthesia. Performing the procedure under local anesthesia significantly improves recovery after surgery and makes it safer by avoiding the potential risks of general anesthetics.

A critically important concept to know is that the result of liposuction ultimately relies on having skin with good elasticity. If the elasticity is good, the skin is going to contract, redrape, and take the shape of a new sculpted area. On the other hand, if the elasticity is not good, the fat will be mostly gone, but the skin may hang loose and may form folds. The degree of skin contraction depends primarily on your genetics. For instance, you may know a woman who has been pregnant, and some months after delivery, her abdomen looks flawless and flat. On the other hand, you may know a woman of a similar age and body type who, after delivery, has excess skin, folds, and stretch marks on her abdomen. Why does this happen to one person and not the other? Primarily from the individual’s genetics.

Some people have genetic characteristics that produce skin with more elasticity and resiliency to stretch marks. A similar situation is why some friends with similar lifestyles tend to age more than others. Some technologies we use, such as Renuvion® J Plasma or Retraction® radiofrequency, help tighten the skin during liposuction. Please check our “FULL TECH Lipo” (link) approach.

When someone already has excess skin, in addition to the liposuction, some of the extra skin should be ideally removed to avoid further redundancy, such as by doing an abdominoplasty. To further make the point, liposuction tends to create skin redundancy, giving fat (deflates the area), which creates more relative excess skin. If the amount of liposuction is minor, the quality of the skin is good, and the individual has good genetics, the results will likely be excellent. If the amount of liposuction required is large, the quality of the skin is poor, and the person is older and/or does not have good genetics, the results will not be as good.

In summary, when there is excess skin, and a liposuction is carried out, you have to pick between two compromises. The first is to accept some residual skin after surgery, and the second is to accept a scar from the consequence of removing the extra skin. Despite the fact that these scars can last a long time, fortunately, most people heal very well and are happy with their decision. Therefore, women who have abundant stretch marks after childbearing, or both men and women after significant weight loss, are typically not good candidates for liposuction. This is because when the skin has stretched too much in the past, it is unable to contract fully later in life.

Age is also an important factor. The older we get, the less ideal candidates for liposuction we become. This is because we lose skin elasticity as we age. An example that I give to patients is the following, at almost opposite extremes in age: Think about the result of a chubby and overweight adolescent losing weight versus a similar person in his 70s. The chubby young person has a much better chance of looking normal or nearly normal than the older one, whose skin almost has a 100% chance of hanging and becoming loose.

The younger and the more skin elasticity you have (based on your genetics, independent of the age), the better candidate for liposuction you are. Good nutrition is also extremely important. For older patients, some technology we use, such as Renuvion® J Plasma or Retraction® RarioFrequency, helps to tighten the skin during the liposuction procedure. Please check our “FULL TECH Lipo” approach.

Most people see results immediately. However, it is important to understand that the results in cases where liposuction is carried out may not be visible until about six months after surgery, when most (but not all) of the swelling has disappeared. Most people see an improvement almost immediately or three months after surgery. In case of re-operations or revisions, it is best to wait nine to twelve months after the initial surgery.

As you can see, liposuction results depend on many factors (“multifactorial”). Lastly, the amount of liposuction performed in the outpatient setting in the state of Florida is limited to 4 liters. Nevertheless, surgery may be terminated before reaching this number due to several factors, such as the amount of blood retrieved in the liposuction aspirate. A personal consultation will determine what is best for you.

You have localized areas of unwanted fat that are resistant to diet and exercise, disproportionate to the rest of your body, and have good skin elasticity. You want better proportions and sleeker contours.