About 11,000 body contouring operations are performed in Germany each year. Reasons for abdominal aesthetic surgery are loose or excessive skin, superficial fat hypertrophy, and diastasis of the muscular wall. In cases of excessively thick subcutaneous fat, liposuction of the abdomen, flanks, and mons pubis can be done. Careful preoperative planning is critical for acceptable cosmetic results. This includes marking the incisions and photodocumentation. Early local complications such as infection, bleeding, and healing disturbances occur in 0.5–7% of all cases. Typical complications later are seroma and sensibility and cosmetic problems (1–4%). There are reported deaths by thromboembolic complications, intra-abdominal perforation, anaesthetic complications, and fat embolism.