“Yes, it does appear that Pauly may have had abdominal etching performed,” Dr. You told us. “This is a cosmetic surgery where liposuction is used to sculpt fat around the edges of the abdominal muscles to make it look like someone has a six-pack. Basically, the fat is removed from the periphery of the muscles to make the muscles look bigger and more defined. This is a growing procedure among men.”

Despite the popularity of the procedure, Dr. You admitted there could be long term risks. “The main concern with this operation is long term. How does it change when the skin gets looser with age? Does the six-pack turn into a party ball or a broken keg?” he asked. When it comes to why Dr. You thinks Pauly may have had the surgery, it’s all because of his body type. “The easiest way to spot etching is a very well defined six-pack on a man who isn’t lean enough to naturally have one,” he explained. “If the muscles around the six-pack, like the lats and rib muscles aren’t also well-defined, then that six-pack could be enhanced.”

Dr. Moretz agreed with Dr. You’s thoughts about Pauly having the procedure done. “Based on the photographs [in Cancun], yes it looks like ( Pauly ‘s six-pack) could be the result of abdominal etching to enhance the size of his muscles,” Dr. Moretz said. “If you look at the form of the ‘six-pack’, you see that the lines between the muscles are totally horizontal. In real life, though, the tendons between the heads of the rectus muscles slope downward slightly kind of like the limbs on a Christmas tree do from the trunk. Also, each of these muscles looks like it has a smooth rounded edge which is also not anatomically correct. Muscles in the rectus pack tend to be more of a trapezoidal shape and have an angle towards their edge into the tendon sheath, not a smooth curve like a breast.”

“This is indicative of fat sculpting without taking attention to appropriate shaping of the fat to look like a muscle,” Dr. Moretz continued. “Muscle has angularity to its shape and form, whereas fat has rounded curves only. If you also look below his belly button on this picture there looks to be some contour irregularities which could be the result of slightly uneven fat removal with liposuction.”