Not all abdominoplasty operations are the same and a flexible approach is required to tailor the operation to the patient. Some patients have predominantly muscle weakness while others have more excess skin. This influences the choice of procedure required to obtain the best possible result. The scar in a full abdominoplasty is long and careful planning of the incision and suturing of the skin is required to conceal and minimize the scar. I never use an assistant to suture and do all of this part of the operation myself.