Abstract :The abdomen is among the most frequently requested regions for undergoing liposuction. However, liposuction alone is not always sufficient to address abdominal bulging, and it is likely that patients will require skin removal and muscle tightening by a secondary abdominoplasty. Few data exist in the literature regarding the limitations of secondary abdominoplasties following a previous liposuction. It is believed that because of skin retraction and tightening, much less skin can be removed than in a primary abdominoplasty. We report on a 70-year-old woman with significant abdominal bulging who underwent a primary liposuction but remained unhappy with the result. During a secondary abdominoplasty, the abdominal flap was widely undermined, and musculofascial repair and a pubic lift were added. However, it was not possible to excise the entire skin of the lower abdomen, and the defect resulting from the umbilicus excision left a vertical midline scar just above the horizontal scar. If we had resected the entire skin of the lower abdomen en bloc, major difficulties would have been encountered to close the wound. Because barriers to perform liposuctions are continually decreasing, young nulliparous women in particular should be informed that liposuction of the abdomen limits secondary abdominoplasties.