Six-pack abs, washboard abs—call them what you will, but the uber-etched and defined look truly takes flat tummies to another level. And while it may seem like they’re the result of a strict diet and hours in the gym, that’s not always the case.
It’s also important to note that, from a purely biological standpoint, not every individual is able to achieve this type of muscular definition on their own, no matter how diligent they may be. “A six-pack is due to the presence of fibrous inscriptions, or bands that cross the rectus abdominis muscle,” explains Dr. Farah Naz Khan, a board-certified plastic surgeon in Dallas. “When there is little fat on top of the muscle, the muscle definition is clearly seen. The fibrous brands break it up even further, creating the appearance of a six-pack.”
However, not everyone is born with these bands—women less frequently than men—and not everyone’s bands lie across the rectus abdominis in the same way. Point being, you can be in great shape and have a superstrong core but still struggle to achieve that cut look by traditional means.
Here’s where cosmetic procedures can help, making it possible for many women to achieve a six-pack—or, at least, the illusion of one. And these aren’t just options for those in the bodybuilding world. Yes, this is a way for hard-core fitness enthusiasts to make that last-mile change, but these are also a nice choice for those in search of a catalyst that will help them take the first step toward changing their body, notes Dr. Ryan Neinstein, a board-certified plastic surgeon in New York City. Particularly when combined with good ol’ fashioned diet and exercise, certain procedures can go a long way toward helping sculpt and define your abs in ways that might not otherwise be possible. Ahead, more on how three trending treatments can do exactly that.
The tummy tuck
Achieving a six-pack can be especially challenging for women who’ve had children. Pregnancy often causes the rectus abdominis muscles to spread apart—a condition known as diastis recti. For many moms, those muscles will never come together post-baby without surgical intervention, notes New York City board-certified plastic surgeon Dr. Melissa Doft. (She adds that no amount of core-crushing workouts can repair diastasis recti). Ensuring these muscles are properly aligned is the first step in scoring a six-pack. During a tummy tuck, the gap between them is closed as the muscles are plicated, or sewn together with sutures, for a flatter, firmer effect.
Tummy tuck patients who are within 10 to 15 pounds of their goal weight will have the best results, says Dr. Khan, although liposuction is sometimes performed during a tummy tuck as well. By removing the layer of fat over the muscles, the muscles become more noticeable, she says. (This can be particularly helpful for women, given that they naturally tend to store more fat in the stomach area than men, simply due to evolutionary purposes, notes Dr. Neinstein) Still, Dr. Khan is quick to note that if you don’t have those aforementioned fibrous bands, a tummy tuck can definitely help flatten your stomach and bring your muscles together, but it won’t deliver a six-pack. And regardless, toning and strengthening the muscles is still paramount. (More on that in a minute.)
Liposculpting
Also known as liposculpture, etching, or high-definition liposuction, this technique involves strategically removing fat around the muscle to create the illusion of a six-pack, says Dr. Doft. (The procedure is a 2019, 2020, and 2022 RealSelf Most Worth It Honoree, with members giving it a 92% Worth It Rating.) In short, it’s a much more targeted type of liposuction, with the intended result being the appearance of more defined muscles. You’re not actually carving or creating muscles but rather carefully sculpting above and beside them and helping to bring the skin closer to the muscle, explains Dr. Neinstein.
Dr. Khan prefers liposculpting with fat grafting when aiming to create the illusion of a six-pack in people who don’t have the fibrous bands present, she says. Areas of indentation mimic the sites of the muscular inscription, while slightly protruding areas of fat, strategically placed, can enhance the look of muscles, she explains.
Emsculpt
Once you’ve addressed the issues of muscle positioning and excess fat, you still need to ensure the actual muscles are strong and toned enough to be noticeable. Classic core-strengthening exercises—planks, crunches, sit-ups—are, of course, a proven way to go, but for an extra no-pain-all-gain boost, there’s EmSculpt.
“The device’s electromagnetic energy stimulates specific muscle cells, to sculpt and strengthen the core,” says Dr. Neinstein. “All tummy tuck and lipo patients can benefit.”
Much like going to the gym, you’ll need to commit to having these procedures on a regular basis. If you stop, you’ll lose the definition you’ve gained, notes Dr. Khan. She recommends waiting eight weeks after any type of abdominal surgery to start. An initial series of four weekly treatments typically yields best results. Dr. Khan tells us that many of her patients return for a monthly maintenance treatment, while Dr. Neinstein says these can be done every three months.
A few other things to keep in mind
Any kind of six-pack should always look natural
The goal is always a naturally athletic look, says Dr. Neinstein. “The skin should still flow over the muscle. Overdone sculpting tends to have a ‘stuck on’ appearance,” he adds. You also want to make sure all the areas of contour are even, without any divots or irregularities, such as out-of-place indents or fatty pockets, says Dr. Doft. And finally, any scars should be hidden and not easily visible, notes Dr. Kahn.
Lymphatic massage is a good add-on
This is especially true if you’re someone who is already very fit, with well-defined muscle tone, and using one of the two aforementioned surgical procedures as the icing on the cake. “Incorporating lymphatic massage after liposuction or a tummy tuck is an excellent way to make your results visible faster,” suggests Dr. Doft. While not every surgeon views it as a must post-surgery, it does help promote fluid drainage and reduce swelling, she says. Most of her patients undergo four to six massages, starting one week post-procedure.
