3 months ago, I had six pack surgery. First pic is 1 month post, second after 3 months. Why does the second look worse? (Photo)

Thank you for questions regarding VASER hi-def 6 pack or abdominal etching.  Thank you for including your pictures.  What you are showing in your pictures is a very common time sequence.  One month after your surgery, you are still healing.  In fact, it can take many months to see the final results.  During the first 4 to 8 weeks, you will have episodic swelling.  I believe in the first picture, you have swelling around the surgical areas and even swelling within the muscle itself.  Your picture 3 months after surgery is more accurate because most of the swelling is gone.  In addition, I believe you have probably burned more fat and burned some of the fat that still remained on top of the rectus muscle.  Therefore, in the second picture, the swelling is gone, you have probably lost even more fat.  You should also get a scale to weigh your percent body fat.  I believe in the first picture; your body fat was higher than your second picture.  This would correlate to loss of "muscle definition" of the anterior abdominal wall.  Thank you for your excellent question regarding the appearance of your abdomen after VASER hi-def or 6-pack abdominal etching.  If you have any more questions regarding the VASER hi-def 6-pack surgery or abdominal etching in general, please contact my office.  Sincerely, Dr. Katzen

You have swelling which can last 3-6 months after your procedure.  To improve your final results, I also recommend adding vanquish for further fat removal, exilis/venus legacy for skin tightening, cellutone/z wave to make the skin smooth, remove scar tissue, and improve the skin’s appearance. See an expert. Best, Dr. Emer

Hello,I see your concern.  In my opinion at two months you are in the initial phase of healing.  It is too soon to judge, let alone if you need a touch up procedure.  In the initial 4 to 6 months I recommend optimizing your healing by weight stability, regular activity, focal massage, and low salt diet.Best wishes,Dr Sergio Maggidrmaggi.com

Hi Aiste1234, It is a common question in my office from patients who came with a previous Abdominal etching complaining of worsening in the results. I may tell you:
 You must wait until the swelling dissapears, it could take more or less than 12 months, during this time, the great work that your doctor did will be more obvious.I will say that there is 2 types of Abdominal etching: With lipoinjection and without lipoinjection. The first one maybe in the short term will provide the best aspect, because you will see a big well defined six pack, but with the time, if you gain weight again it will take the form of a six lumps instead of a six pack. In the same way, if you loose weight, your six pack could get smaller. In the other hand, the Abdominal etching without lipoijection, requieres a previously abdominal rectus muscles well defined or almost palpable on the exam, like Dr. Pober said before. In this way when the fat is aspirated the six pack gets a better definition.Speak to your surgeon, he may help you to understand better your actual situation because he performed the procedure.
Best of luck,

Your have a nice result. 3 months is an early stage and your final outcome should be judge closer to 1 year. Not a clear explanation why it would look better before but neither before or at 3 months is the true final result. Talk to your surgeon if you have questions and give yourself some more time to recover. Continue with your workout, it can only make it better. Good luck!

It is most likely just swelling. Cut down on your salt intake to reduce the swelling as well. It will take a few months for the swelling to fully reduce. 

It is hard to say what the reason may be, perhaps swelling.
However,its critical to understand the basis for abdominal six pack etching.


When a patient requests detailed abdominal etching to create
an end result of a full “six pack” look, I have repeated emphasized that it is important that the patient
already have a full six-pack palpable on examination.  The rationale is simple: the detailed
differential liposculpture plan requires and is designed along the preexisting
anatomy.  In other words, abdominal
etching “accentuates” the pre-existing three tendinous intersections of the rectus
abdominus muscle: one at the xiphoid, one at the umbilicus, and another in
between these two regions, as well as the linea alba and semilunar crescents. The plastic surgeon must follow the pre-existing
curves of the six pack in his liposculpture to obtain not only a natural result,
but a result  that is enhanced with further
exercise. Otherwise  further exercise and
weight loss will tend to display the preexisting inscriptions of the rectus
definition and to simultaneously compete with the artificially placed “overly symmetric six-pack,
stamped-on design” that doesn’t follow your own true anatomy.  This lack of respect for the pre-existing (often
asymmetric) six-pack anatomy of the patient leads to poor results long term for
the devoted body builder, seeking to max out his look.


Chances are your surgeon did precisely this, and as the
swelling resolves your six pack will regain its prior definition.   


 At the end of the day,
it’s critical that anyone contemplating abdominal etching have an
individualized consultation  with a board certified plastic  
surgeon whose aesthetic perspective, personality, educational background,
talent, training and experience with your needs and wants  makes you
comfortable,  and you believe can help you achieve your aesthetic goals


I wish you well in your recovery and end result of an envied
six-pack abdomen!  


Joseph Pober, MD,FACS


Harvard - Trained Plastic Surgeon