This retrospective study was aimed to assess the clinical role of simultaneous liposuction, extent of skin undermining, and progressive tension suture on seroma formation following abdominoplasty. A chart review of 121 patients was done and divided in three groups. Group A included patients with abdominoplasty and liposuction of flanks. Group B included with abdominoplasty, liposuction of flanks, and progressive tension sutures. Group C had abdominoplasty, limited supraumbilical undermining, progressive tension sutures, liposuction of the abdominal wall and flanks. Seroma formation was based on the presence of fluctuant swelling in hypogastric area. Group A included 53 patients, had 1,096 g tissue excised (range 98-5,812) with an average liposuction of 854 cc with incidence of 26% seroma. Group B included 24 patients, with an average removal of 997 g tissue (range 75-2,440) with an average liposuction of 700 cc and an incidence of 7.7% seroma. Group C included 44 patients, had on average 803 g tissue excised (range 76-2,092) with an average liposuction of 816 and 610 cc from flanks and abdominal wall, respectively. There was 0% seroma formation. Statistical analysis was performed using ANOVA test and showed no statistical difference between tissue excised (p=0.18) and liposuction performed (p=0.25) on the hips and flanks. Blood loss (p< 0.001) and first 24 h drainage (p<0.001) were significantly reduced in patients with progressive tension sutures and limited supraumbilical undermining. There was a significant reduction in seroma formation (p < 0.001) when progressive tension sutures were used with limited supraumbilical undermining and analyzed using Fischer exact test.