Background: Abdominoplasty continues to be a frequently performed plastic surgery procedure. Futhermore, an increase in both surgical and medical weight loss is contributing to the procedure's increasing popularity. Technical refinements have improved surgical outcomes and safety. Despite this, it remains a procedure with one of the highest morbidity and mortality risks in aesthetic plastic surgery. Methods: A review of abdominoplasty complications and best practices was performed in order to provide a succinct review of the most prevalent safety issues in abdominoplasty surgery. Proposal: In order to mitigate the risk of complications, risk stratification, patient selection, and using evidence-based techniques are essential. In the present study, the authors provide recommendations for approaching the most common safety considerations of this procedure. Conclusion: Appropriate patient selection, surgical technique and proper protocols, ensures surgeons control the modifiable risk factors that increase complications. Implementing nonpharmacologic and pharmacologic interventions reduce the risk of venous thromboembolism. Using evidence-based techniques tailored to the specific patient's anatomy ensures the vascular territories of the abdominoplasty flap are respected and perfusion for wound healing is optimized.