Not all six pack abs look the same

Four Pack Abs

Many men who dream of a six pack often trawl through fitness magazines or search through the internet, looking for the ideal looking six pack that they would like to achieve. However, even if they reach the desired body fat % and muscular physique to reveal their six pack. they may not be happy with their results because of their very individual anatomy.

You see, we are all very different and have our own muscle shapes and sizes and these are genetically predetermined. This is what I have to explain to all my VASER 4D liposuction patients, because I am only going to be able reveal their natural anatomy and not create a 'perfect six pack' if they don't have one.

If your surgeon disregards your own natural anatomy and gives you a 'perfect' shaped sixpack, when you naturally have a 4-pack or an 8-pack, then the results are going to look extremely unnatural. This is no more than the outdated method of abdominal etching and not the highly advanced Vaser 4D Sculpt technique.

Not all sixpacks look the same

For sure, most male patients have a six pack, but the exact layout is very different. Some lie above the umbilicus, while other start below the umbilicus as seen above. Some men have 10-pack while others

have only a 4-pack.


In patients whose muscular anatomy is very obvious during their consultation, I perform an ultrasound scan to help locate their muscles, so that their VASER 4D liposuction surgery provides the most natural looking results possible.

Vaser Lipo Pre-op Instructions

Once you have made a decision to proceed with VASER Lipo I tend to advise my patients the following pre-op instructions:

4 weeks before surgery

• Start high intensity interval training 3-4 times a week. This will help to burn up any internal fat, which cannot be removed during surgery.
• Try to introduce a gluten-free diet to reduce bloating and also some excess fat.
• Start taking slimming teas such as Jade Fusion every day to help reduce weight further. You will need about 4-6 cups a day.
• Stop smoking as this significantly increases the chances of infection, wound complications and anaesthetic problems.

2 weeks before surgery

• Stop alcohol intake as this will thin your blood and increase blood loss during surgery
• Attend your pre-op assessment with my nurse where you will receive your prescription for your surgery, and be fitted for your compression garments. You will also be risk assessed for deep vein thrombosis and any anaesthetic risks. At this appointment any outstanding balances will need to be settled.

24 hours before surgery

• Pack your day bag for surgery day to include loose fitting clothing of dark colours
• Take your prescribed medications as instructed, so make sure you have collected them from your local pharmacy.
• Drink lots of water - about 3-4 litres of water during the day before surgery to hydrate yourself which will help speed up your recovery
• Have a really good 'cheat meal'!
• Do not eat or drink 8 hours before your surgery time

Who is the ideal patient for VASER Lipo?

I was asked this question by The Good Surgeon Guide on my twitter feed last week, and its a great question.

Contrary to popular belief, VASER Lipo can be used on all sorts of body sizes, though the best results come from those who are NOT that overweight. Clinically obese people (i.e. those with a BMI of over 30 unless extremely muscular) who are looking for a surgical solution to weight loss should see a bariatric surgeon instead, as VASER lipo is not about weight loss but about reshaping your body.

So who is the ideal patient?

Well, from the last 350 patients I have treated, I can say that the ideal patient is male or female, with an age of 38 years old, weighs in at about 75KG and has a BMI of 26.

Before and After VASER to Abs, Flanks and Hips

So as you can see, our VASER patients are generally not overweight but do have trouble spots they want rid of. The split between male (37%) and female patients (64%) is narrowing each year and I suspect in 5 years I will treat as many men as women.

So what sort of areas do patients request to have treated?

Below are my top 5 treatment requests for VASER Lipo:

1. Abdomens & Love Handles 
2. Gynaecomastia (Man Boobs)
3. Saddle bags (Outer thighs)
4. Double chins
5. Upper Arms

The demand for VASER 4D body sculpting is increasing at a dramatic rate and its not surprising as for many its a much more cost effective solution that having all of the above areas treated individually. On top of that, you also get a much more athletic look.

Before and After VASER 4D Sculpt

If you would like to schedule a consultation with Dr Jain, please fill out our enquiry form or call 08000325415.

Written by Ravi Jain

Can I have Vaser 4D Sculpt if I've had liposuction before?

Many of our Vaser 4D Sculpt patients have had liposuction before but now want to benefit from the sculpting effects of this new technique. Patients who have had a liposuction before will be referred to as 'secondary patients'. They often are not aware that their previous liposuction will make any future procedures much more challenging with greater risks and more unpredictable results. So during a detailed consultation with me, I always explain the following points:

• The previous liposuction will have caused fibrosis (scar tissue) beneath the skin and sometimes this is quite dense. Dense fibrosis raises the risks of perforation and uneven results because more force is required to pass the instruments through the tissues. However, the Vaser 2.0 Lipo system, delivers ultrasound energy much more efficiently and this copes very well with fibrotic tissues.
• When trying to create a six-pack or High Definition Liposculpture, the lines may not be as obvious during the surgery due to the fibrosis. In a patient who has not had lipo before, the sculpting is more obvious because only fat is sculpted. However, in a lipo (secondary) patient, the sculpting is done in both fibrotic and fatty layers and because the fibrotic layers are more stiff, they do not necessarily reveal their new shape straight away.
• There will be much more inflammation and swelling in secondary cases because there will be generally more trauma and blood loss when compared to first timers. As such, more aftercare sessions are generally required over a longer time and results may take much longer to develop (even up to a year). The strength of the definition achieved is much more unpredictable due to the prolonged, although patients will be slimmer and there will be a hint of definition in the worst case scenario.

For a full consultation with Dr Ravi Jain in London or Harpenden, please call 01582 762877 now.

What happens if I put on weight after Vaser?

I get asked this question a lot and during my consultations I make sure this is covered even when it is not asked as it is an important fact which needs to be considered. Lets first explain how fat is deposited in adults.

pinching subcutaneous fat

Adults have a finite amount of fat cells and not usually grow any more fat cells. When people put on weight, their current fat cells simply expand, and when they lose weight, these cells shrink again. Men and women lay down fat differently. Women tend to lay down fat under the skin and around the abdomen. This is called peripheral fat or subcutaneous fat and is easily pinchable around the waistline. Only when women are obese do they tend to put down fat internally around the organs.

On the other hand, men tend to put down fat inside the abdomen, around the internal organs first. When they are obese they then lay down fat under the skin. This has important consequences as internal fat or 'visceral fat' can lead to heart disease, diabetes and cancers. So it is very important for men to lose visceral fat to prolong their lifespan. However, most men have both peripheral and visceral fat present especially those that work out, and there may be more peripheral than visceral fat present in such individuals. If so, they maybe suitable candidates for Vaser 4D Lipo.

before & after Vaser 4D Sculpt

Liposuction gets rid of peripheral fat very effectively and it is this fat which we sculpt in Vaser 4D Sculpting.  On the other hand, visceral fat cannot be treated with liposuction! The only way to get rid of visceral fat is through lifestyle changes. However, the good news is that visceral fat responds very well to lifestyle changes such as diet and exercise. On the other hand, peripheral fat responds more slowly and that is why many people get frustrated when they can't lose more weight around their waistline despite shrinking the size of the tummies.



So what happens if you gain weight after liposuction?
After liposuction, there is a reduced amount of peripheral fat in the body. So when someone's lifestyle becomes more sedentary the body will lay down fat. But if there is no peripheral fat to absorb this extra fat, then the next place to take it is the internal visceral fat, inside the abdomen and thorax. This is very unhealthy for reasons explained above. The other areas which may grow are areas of untreated peripheral fat such as the buttocks or breasts. So if someone does put on weight after Vaser, they may get bigger buttocks or breasts or their tummies may swell.

This is why any form of liposuction should NOT be used as a weight loss alternative but more of a option for getting rid of stubborn areas in patients who are only slightly overweight. Vaser 4D Sculpt can be used to treat patients who were previously considered to be too slim for traditional liposuction and this has opened up sculpting possibilities for a whole new population.

If you need more Vaser Lipo information contact our friendly team on 01582 762 877 now!

Can I have Vaser Hi Def if I've already had liposuction?

Many of my patients at Riverbanks are patients who have previously had liposuction but now want a sculptured look rather than a flat, boxed shape. Others have had liposuction elsewhere, previously, and are not happy with their results so they have come to me to try and improve them. For many of these patients the only option is Vaser Hi Def or Vaser 4D Sculpting as the only layer of fat left behind is in the superficial layer, which is not usually amenable to traditional liposuction techniques.

When treating patients who have already had liposuction, it is important to wait at least a year from the previous surgery so that the tissues have stopped healing. There is often a degree of scar tissue (fibrosis) in the remaining fatty layers and this will make the operation more challenging and also slightly more bloody  than a first time case. The amount of definition achievable can vary between individuals but is generally only slight less than with a first time case. It depends on how much fat was left behind after the previous surgery.

4D Sculpt results correcting a failed Smartlipo treatment

The healing will be much longer though and aftercare sessions at the clinic are essential in order to facilitate the healing of the treated areas. It is important to stimulate the lymphatic drainage channels and encourage new vascularity of the treated areas and this is achieved with specialised aftercare at Riverbanks. I generally advise patients who had already had a liposuction and want high definition liposculpture to book in for 10-20 aftercare sessions over 4-6 weeks.

Your results will take a bit longer to show. You will see good changes immediately but the swelling will last for a few weeks and the first signs will show at 6 weeks. We will review you at 3 months, 6 months and 12 months post op.

For more information you can call 01582 762 877 or book a consultation. 

Vaser 4D Sculpt to the arms

Many men & women prefer to have more defined arms allowing them to look better at the gym or just with short sleeves. There are subtle differences between the two sexes which need to be considered. Women prefer smaller arms with slight definition of the deltoids. The lower border of the upper arm should be straighter with slight curvature at each end, defining the triceps. It is key not to make the female arm too defined or bulky.

Female 4D Sculpt definition by Dr Alfredo Hoyos

Men, on the other hand,  like bulkier biceps and triceps with well-defined deltoids. It is important not to shrink the size of the male upper arm. We can give the illusion of a bigger biceps by sculpting the fat around the biceps and the deltoid creating a horseshoe effect, often sought after at the gym. Care must be taken to compensate for the natural movement of the muscles and this is identified and marked during your pre-op examination. It is also possible to transfer some fat into your deltoids to further boost their volume.

Male 4D Sculpt definition by Dr Alfredo Hoyos

Find out more information on Vaser 4D Sculpt or other types of liposuction on our full website. You can book an appointment with one of our surgeons in London or Harpenden by calling 0158 276 2877.

Male Breast Reduction with Vaser 4D Sculpt

All of our vaser patients during 2011 requested to have their chests reduced in size with our Vaser 2.0 Lipo system. This was often in combination with treating other areas such as Vaser 4D, but for many reducing the size of their breasts was their primary concern.

Some of our men needed only sculpting while others required significant debulking of fatty breast tissue with some gland excision. The exact nature of your surgery will be discussed during your consultation with your doctor.

Vaser 4D allows the surgeon not only to debulk your chest and reduce it size but to also reshape your chest providing a more athletic shape. Athletic chests often have straighter lower sides and a straight edge towards the armpit. More feminine chests are rounded and fuller in the lower half of the breast. If one works out, the pectoral muscle will bulk up in the upper half of the breast rather than the lower half. It are these fine details which will be in the surgeons mind when he reshapes your breast during a Vaser 4D Sculpting procedure. In order to bulk up the pectoral muscles, fat may be moved from one part of your body to the pecs with Fat Transfer. After all, who has six pack abs without defined pecs?

For more information about Vaser 4D Sculpt or Male Breast Reduction surgery at
Riverbanks, it is best to book an appointment with one of our surgeons. Call 01582 762 877 now for consultations in Harley Street or Harpenden.

Vaser 4D patient talks to SKY News

Lee was treated at Riverbanks Clinic by Dr Jain. His original surgery was filmed for MTV in Dec 2011. Watch this clip form Sky News, aired 30/1/12, discussing male cosmetic surgery.

It should be noted that Vaser 4D is NOT a weight loss solution but gives men who are self conscious about their physique an option to develop an abdominal six pack and defined body without having to resort to the extreme diet and lifestyle normally required without surgery. A healthier lifestyle is required after surgery to maintain and maximise the results. Complications can occur during or as a result of any surgery, and rarely these can be life threatening.

For more information about Vaser 4D Sculpting, see our full website.

Whats the difference between Vaser 4D Sculpt & Vaser Hi Def?

There is no denying that the VASER Hi-Def technique was one of the most influential body contouring procedures in the last decade. However, even earthshakers have their flaws. And as Dr. Hoyos worked more and more with Hi-Def, he realized the multiple flaws the procedure presented.

That is why he went back to the drawing board, re-imagined his creation, and has now released 4D Sculpt™ which is what I practice exclusively at Riverbanks Clinic.

The differences between 4D Sculpt™ and Hi-Def may be subtle, but when applied in the operating room, the nuances are distinctly profound. 4D Sculpt™ means the difference between clunky sculpture and natural human beauty.

Here is an in-depth explanation of the differences between VASER Hi-Def and the highly improved version, 4D Sculpt™.




VASER 4D Sculpt takes into account natural muscle movements.

VASER Hi-Def results often do not show the muscles in motion. It does not incorporate the natural progression of the body in motion. This can give rise to an 'etched' appearance rather than a natural six  pack.

How 4D Sculpt™ Fixes It:
4D Sculpt™ uses a customized combination of anatomical landmarks to prevent deformities. This ensures the newly defined muscles do what muscles are supposed to do: move! That is why 4D Sculpt™ is called 4 dimensional liposculpture. It uses height, width, depth, and dynamic motion. 4D Sculpt™ makes the natural progression of the body apparent according to muscle activity.



VASER Hi-Def is a “One Size Fits All” Procedure.

Aesthetic surgeons probably know better than anyone that every body is unique. Trying to fit a 300lb man and a 125lb woman is ineffective and produces exactly what it looks like, a “one size fits all” result. This attitude of VASER Hi-Def toward the patient causes the surgeon to be biased toward each patient, as though every body type were the same, and every individual patient just like the last.

How 4D Sculpt™ Fixes It:

4D Sculpt™ is a completely customizable procedure that takes every variable into account. A woman hoping to reverse the signs of pregnancy will be viewed much differently than a man with an excess of intraabdominal fat. An example of variables include: age, gender, body type, muscular motion, predicted weight loss, post-pregnancy markers, and so on. Every individual has their own set of different anatomical landmarks that must be taken into consideration for the final result to look like the patient’s natural body.



VASER Hi-Def is Not Dynamic Definition.

VASER Hi-Def results often appear stiff and do not move fluidly with the rest of the body. This is partially because of both the reasons stated above, because VASER Hi-Def does not plan according to each body type or according to where the muscles will move in the future. Dynamic definition encompasses the ideals of 4D Sculpt™, in that once the muscles are defined, they do not appear as though they’ve been carved out of plastic.

How 4D Sculpt™ Fixes It:
4D Sculpt™ fixes a “plastic” appearance that not only incorporates motion, but flows with it. It does this by integrating a second set of pre-surgical markings, drawn according to the patient’s muscles in a static position and in dynamic motion.

4 weeks after Vaser 4D as seen on MTV

VASER 4D Sculpt incorporates much more intensive aftercare than Hi def and this reduces the risks of complications and also speeds up recovery as well as enhancing results. You can watch a video of a treatment session here.

Click here to schedule an appointment with Dr Ravi Jain at Riverbanks Clinic or at his Harley Street consulting rooms.

Riverbanks & Vaser 4D featured on MTV

When we were asked to feature on an MTV documentary discussing the various options available to a young girl who is not happy in her own body, we were very concerned that the right message would be portrayed to her and the show's target audience. Liposuction is NOT a treatment for weight loss and should not be considered as a first option for any form of body contouring. However, for those who have honestly tried their best with diet & exercise and still find it difficult to shift those unwanted bulges, or show off their six packs, Vaser 4D Sculpting is a good, if not extreme option.

Sophie Kasaei at Riverbanks Clinic

Sophie Kasaei, star of MTV's Geordie Shores, created the documentary 'Get Thin or Die Tryin' especially for MTV in which she went on a journey to try and decided if liposuction was the right option for her. She spoke to her friends, people who have had liposuction with good results and also to one lady who had suffered horrific complications from a laser assisted liposuction. When Sophie visited Riverbanks, she met with myself, Dr Ravi Jain and my colleague Dr Alfredo Hoyos. We explained to her in the ins and outs of Vaser Liposuction and Vaser 4D Sculpting (not all of which were included in the final edit).

Sophie even got the chance to speak to one of our male patients who was about to have his 4D Sculpting procedure at the clinic. We dressed Sophie up in our brand new Riverbanks scrubs, and invited her into the operating room and watched Dr Jain carve six pack abs into the patient using the latest Vaser 4D Sculpting techniques with Dr Hoyos commentating.

I think Sophie (and the camera crew) did very well not to pass out as the procedure can be quite gory to the unaccustomed! Sophie gave a frank and honest overview of the surgery and we found her conclusions absolutely spot on. Sophie made the right decision for her. If she really wants the body she is after, then we would advise her to invest in a personal fitness & nutrition trainer for at least 6 months. If after that she wants an extra boost, then Vaser 4D maybe a good option.

You can watch the highlights of the show here:

For more information on Vaser 4D Sculpting at Riverbanks visit our website

Are the results from Vaser 4D permanent?

This is one of the most frequently asked questions I hear during my new patient clinics both in London and at my flagship clinic just outside Harpenden. Essentially, the effects of the treatment are permanent but in order to make them look natural, you stil have to make adjustments to your lifestyle. Let me explain.

Vaser 4D Sculpting uses highly advanced ultrasound-assisted-liposuction techniques to create an athletically shaped body. A large percentage of the body fat which sits just beneath the skin, is removed and if necessary transferred to other parts of the body to enhance the natural curves (eg. pectoral muscles and buttocks).

In order to enhance the appearance of certain muscle groups (such as the rectus abdominus or serratus anteriors, also known as the six pack and boxers' muscles respectively), I leave a small amount of fat over the muscles creating a bulkier appearance to the muscles.

This sculpting is PERMANENT. The fat that is left behind will expand or shrink depending on your overall nutritional status, just like any other fat. If one does put on more fat after the surgery then this tends to be distributed to areas of the body where fat cells are. Prior to surgery, this would be around your torso. However, as most of the fat cells have been permanently removed now, the fat gets stored elsewhere, such as the buttocks, thighs, face and worst of all, INTERNALLY, around your organs, such as the heart, liver and pancreas. So if one does put on a lot of visceral fat following Vaser Hi Def surgery, you may end up looking like a certain celebrity who appeared on a recent Celebrity Big Brother.

Visceral Fat

Internal fat (also know as visceral fat) is not good for you at all. It increases your risk of various life threatening diseases such as heart disease and cancers. So it is absolutely imperative that following ANY liposuction procedure, you maintain a healthy lifestyle and diet which maximises fat burning.

Many patients who I see at my clinic for lipo struggle with seeing any physical changes from their exercise and that is primarily because their diets are all wrong for their metabolism. Many people struggle to cope with a diet relatively free from bread, pasta, rice, potato and alcohol for at least 6 days of every week. However, this is what is required in many people in order to lose fat while exercising. My personal trainer James Lenaghan has coached me through my dietary & work out changes to maximise the results of my surgery as shown below:

6 months post Vaser 4D
Copyright Ravi Jain

So in summary, Vaser 4D can give you the body of your dreams. It will get you 90% of the way to achieving a natural looking athletic shape. You need to modify your diet and exercise, and then you will get 100% of the way much more quickly and with less drastic lifestyle changes than if you were to do this without surgery.

If you you would like to book a consultation at Riverbanks, please call 01582 762877

Post-Op Aftercare following Vaser 4D Sculpt

If you've researched Vaser Lipo treatments you may have come across some people mentioning the need for after care massages. To be honest, good lymphatic drainage is essential after all forms of lipo and most lymphoedema massage therapists are experienced in treating patients following cosmetic surgery. We have found those listed on MLD UK to be very good at treating our patients who travel from long distances for their regular vaser lipo.

The post-op care following Vaser 4D Sculpt though is much more specialised as it is designed to carefully nuture back the lymphatic system to full functionality following the precise body sculpting which has been carried out during the surgery. The programme has been personally designed by Colombian plastic surgeon, Dr Hoyos, the inventor of Hi def & 4D Sculpt.

Essentially the CARE protocol uses ultrasound therapy, manual lymphatic drainage and pressuretherapy to maximise your results and comfort. We recommend 20 sessions with a minimum of 10 sessions over 2 weeks.

Here is a video of one of Dr Jain's own post op sessions following his surgery: (This video does show patient discomfort and some blood)

Dr Jain is adamant that the VASER aftercare is critical to getting outstanding results and minimising unexpected complications following your surgery. So much so that he invested in his two therapists by sending them to Dr Hoyos's clinic in Colombia to receive the most intensive and up to date training available. Both of our therapists are the ONLY ones in the UK to be trained at Dr Hoyos' clinic in Bogota. By bringing these skills back to Riverbanks, we believe we have the most qualified service for bot surgical and post op care for Vaser 4D Sculpting in the UK.

5 Reasons why it is important to wear compression garments after Vaser Lipo

Vaser Compression Garment

This is probably what people dread the most about any liposuction procedure as they fear the discomfort and constant reminder that they have had surgery. However, if high quality garments are used, it does not need to be such an ordeal as good garments are actually quite supportive and comfortable. Below are 5 reasons why it is such an important step in your care plan:

1. Following liposuction, a potential space has been created in the layers between your skin and your muscles as most of the fat has been removed. This space needs to be constantly compressed in the first few weeks post surgery, in order to prevent collections of fluids such as blood (which could cause a haematoma), inflammatory fluid (which could cause a seroma) or infection.

2. On top of that, good compression garments assists the body's natural lymphatic system, flush away any excess inflammatory fluids from the would sites.

3. The compression ensures that the skin wound edges are closed and so improves the appearance of the scars.

4. The compression helps the skin 'stick' back down to the deeper layers, enhancing the skin retraction and final appearance of your new body.

5. The garments actually make you look slimmer!

What about the compression padding?

4D Vest by Marena

For more extensive liposuction cases such as after treating abdomens or following Vaser Hi Def/4D Sculpt, your surgeon may recommend the addition of a compression foam padding vest to wear UNDER your compression garment for 4 weeks. This is to apply even, consistent pressure around your torso which helps prevent complications such as seroma and also enhances the contour of your new body.

It is a good idea to order at least 2 complete sets of compression hosiery and padding and maybe 3 sets. You may also need a second stage set to use after 3 weeks when most of your swelling has reduced and so your initial garments become too loose.

What are the common complaints with compression garments?

a) It needs 2 people to get them on in the first few days.
b) It can be so tight I can't breathe properly (this is too tight and you should get a bigger size)
c) They have shrunk after washing - only hand wash in cool water and do NOT tumble dry!
d) Its so hot!
e) between weeks 3-6, your skin starts to get its sensation back and this lends itself to experience intense itching! This is very frustrating, but its all a good sign that you are healing well!

So whats a typical timetable for wearing compression garments?

Vaser Lipo - wear the garments for 3 weeks 24/7, then another 3 weeks 12/7
Vaser Hi Def / 4D Sculpt - wear the garments with the foam vest 24/7 for 4 weeks, then just the garments 24/7 for another 4 weeks.

Where can I get compression garments from?
We have used Marena, Macom & Holistic Garments following Vaser. Following his very own 4D Sculpt procedure, Dr Jain used garments from Marena.

If you would like more information about Vaser Lipo at Riverbanks Clinic,
please call 01582 762877 or fill out the form below.