An approach to abdominoplasty has been developed incorporating a series of key surgical maneuvers designed to minimize complications while controlling scar position and eliminating the need for long-term drains. These include sharp defatting of the layer deep to the superficial fascia, progressive tension anchor sutures from the flap to the rectus sheath, and anchor sutures from the superficial fascia to the deep fascia along the line of closure. A retrospective review shows that the rate of postoperative seromas decreased from 33% to 6% with the use of anchor sutures from the flap to the deep fascia.