Background and Objective: Nowadays obesity is a common problem.Obesity can cause abdominal deformation and dissatisfaction regarding body appearance. This study explored the use of a new surgical technique based on a special incision to reform flank skin laxity and dog ear with aggressive liposuction in women with abdominal deformities.
Materials and Methods: From May 2014 to February 2016, 25 women were chosen for this study. All women had a body mass index of greater than 28 kg/m2 in addition to flank folding, bulging and excess fat, abdominal and flank skin sagging and laxity. The new  incision apex was tucked 5-7 centimeters into the medial of the inferior flap. An important point in this new technique was that the paramedian perforator was preserved. 
Results: All women were between 33 and 62 years old (mean age of 47 ± 7.2 years old). The average amount of  liposuction aspirate was 2,350 mL (1700-3200 mL) and the size of the average excised skin ellipse was 23.62×16.08 cm (from 19×15 to 27×18 cm). There was a significant association between body mass index and resolved abdomen and flank fat in the second month after surgery. Dog ear, skin laxity, bulging and fat deposit correction were assessed and scored two and four months after surgery.
Conclusion: Aggressive abdominal and flank liposuction can be safely done while preserving the paramedian perforator. This yields a good cosmetic result in the abdomen and flank and prevents bulging in the incision end and flank. The use of this abdominoplasty technique is recommended for patients with high body mass indexes.