According to Regnault and Daniel, the "fundamental principle of total body contouring is the excision of as much redundant tissue as possible with minimal undermining and moderate tension. Some health researchers are questioning whether body contouring is growing too fast, without a medical consensus on its risks and benefits. Total body contouring is one of the hottest trends in today's cosmetic surgery.

The abdominal deformity is excess skin and subcutaneous tissue and laxity of the abdominal wall musculature. Pregnancy stretches the skin beyond its biomechanical capability to spring back and stretches the musculoaponeurotic structures of the abdominal wall. Massive weight loss, whether from dieting or after a gastric bypass surgery, also plays a role in excess skin and laxity of the abdominal wall.

The most significant area of the defect is around and below the umbilicus, where excess skin over a diastasis of the rectus muscles is most apparent.
The amount, quality, and elasticity of the abdominal wall skin should be thoroughly evaluated.

Liposuction is useful for contouring the abdomen, hips, thighs, back, upper arms, buttocks,knees, neck, chin, calves, and ankles. Liposuction can be performed in a physician's office, outpatient surgery center,or hospital.

In a retrospective study, Kim et al reviewed 118 consecutive patients who underwent abdominoplasty with or without flank liposuction from 1992-2002 and concluded that liposuction of the flanks in concert with abdominoplasty does not increase the risk of seroma formation. Both liposuction and ultrasonic liposuction are extremely effective as single procedures or combined with a more comprehensive body contouring plan.

Body contouring patients are divided into 3 categories: those with normal weight, those who have mild-to-moderate obesity, and those with massive weight loss. Patients who smoke or have diabetes, hypertension, a body mass index greater than category I, or asthmam have significantly higher complication rates.

Patients with localized fat accumulations often desire removal for aesthetic reasons, whereas patients with large, especially circumferential, accumulations desire removal for functional as well as aesthetic reasons. Mass media influences drive what patients expect and desire from an abdominoplasty. In addition, multiparous patients with striae should not expect results exactly as they see in magazines.