Background <p>Massive weight loss often results in residual flank and abdominal redundancy not fully addressed by standard abdominoplasty or belt lipectomy. Recent studies show that oblique flankplasty with lipoabdominoplasty (OFLA) can effectively enhance lateral waist contour and posterior skin laxity with low complication rates.¹⁻³ This study aims to evaluate aesthetic and functional outcomes of OFLA in post–massive weight loss patients at a single center.</p> Methods <p>A prospective observational case series of 35 patients with Type II–III Pitanguy abdominal deformities and Grade 2–3 flank deformities (Pittsburgh classification) who underwent OFLA between June 2024 and June 2025 at Tanta University Hospitals. Data included demographics, BMI, complications, Vancouver Scar Scale (VSS) scores, waist‑hip ratio (WHR), and patient satisfaction. Follow‑up was 6 months.</p> Results <p>Thirty-three females (94.3%) and two males (5.7%) with a mean age of 34.4 ± 5.9 years and mean BMI 33.7 ± 1.7&#xa0;kg/m² were included. The mean pre-operative waist-hip ratio (WHR) improved significantly from 0.93 ± 0.11 to 0.79 ± 0.06 post-operatively (<i>p</i> &lt; 0.001). Overall complication rate was 14.3%, including seroma in 11.4% and minor wound dehiscence in 2.9%, with no infections, revisions, or return to the operating room. Scar quality at 6 months showed a mean Vancouver Scar Scale (VSS) score of 4.8. Patient satisfaction was high, with 60% extremely satisfied and 40% satisfied.</p> Conclusions <p>OFLA is a safe and effective contouring technique for patients with flank and abdominal deformities after massive weight loss, achieving improved waist definition and posterior trunk shape with low complication rates.&#xa0;</p> Level of Evidence <p> Level IV, therapeutic study.</p>