I began to do the "etching" over 15 years ago when it was still very new. It would not be safe to do it with a tummy tuck because it could disrupt the blood flow to the flap and cause the lower aspect of the flap to die (necrosis). In addition, you would not know exactly where to etch since the flap is being pulled downward. The etching would have to be precisely in line with your anatomy in terms of where the segments of rectus muscles are separated. The problem I have seen long-term with etching patients is that the connective tissue that attaches the skin to the muscle gets disrupted. It looks good for a few years, but after 5-10 years, the skin starts to sag due to the loss of the connective tissue attachments.