Although abdominoplasty is a highly customized procedure, most follow a similar pattern. After anesthesia is administered, I make a horizontal incision very low on the abdominal wall. I always try to ensure that the scar will be hidden by a bikini or low-cut jeans. After raising the soft tissue off the abdominal wall, the abdominal muscles are tightened using internal sutures. In many instances, excess fat is removed with the aid of liposuction. Loose, hanging skin is also removed before the final sutures are placed.