A combined abdominoplasty-liposculpture procedure was initially felt to be a rational concept for patients with excessive skin and adiposity. This would theoretically decrease costs and morbidity. The assumption was made upon a review of 500 major abdominoplasties performed with a low complication rate and the fact that liposculpture of the abdomen, when done alone, was quite safe. Combining the two procedures, however, resulted in problems including prolonged drainage, seromas and pseudobursa. Autologous fibrin glue was used and partially corrected the above problems. When all variables are considered, it is concluded that the conservative approach of two lesser procedures may be more efficacious and safer than one larger operation. Liposculpture followed by delayed abdominoplasty is, therefore, felt to be the safest way to recontour the complex abdomen with large amounts of excessive skin and fat.