In the past abdominal lipectomies were the treatment of choice for excessively fat abdomen and panniculous. In cases where skin excess is not a major problem and in younger patients liposuction has brought an interesting armamentarium of techniques for reducing the abdominal wall. In cases with large fat deposits and skin excess, the patient should be warned in advance that the appearance of skin excess with fold formation may look worse since the liposuction will remove the fat and leave skin with poor turgor above it. Another warning is that, postpartum stretch marks cannot be erased. Complications consist of hematoma, bruising, pain, irregularities of the skin if the crisscross technique has not been well-used, seroma and hemorrhage (rare). The technique is discussed with possible complications in this chapter.