It is now widely recognized that the rate of obesity has increased dramatically over the last few decades. Bariatric surgery is the best choice of treatment for extremely obese patients. The proliferation of bariatric surgery has also resulted in the increased use of body contouring surgery to address the hanging, redundant skin that is often seen after dramatic weight loss. Obesity-related issues increase, leading to patients being advised to lose weight to achieve abdominoplasty. The best indication for abdominoplasty is patients with loose skin, rectus muscle diastasis, and minimal abdominal fat. However, obesity related issues are rare, and many obese patients are denied abdominoplasty. A two-step approach involves abdominoplasty followed by liposuction six months later or vice versa. However, both approaches are less ideal due to potential complications, fibrosis, and secondary skin laxity. Abdominoplasty has evolved as a very effective and satisfactory procedure, especially when combined with liposuction and the repair of diastasis recti. However, local complications, including hematoma and seroma formation, flap necrosis, and hypertrophic scars is not uncommon. Sutures are an adjunct in abdominoplasty procedures. Patients are marked in recumbent and standing positions, with planned incisions and liposuction areas. Sequential compression devices are placed before induction, and VTE-prevention modalities are individualized. Posterior liposuction is performed in the prone position. The patient is supine, secured on arm boards, and a pillow is placed under the knees. Wide skin prep and draping is used for midthighs