Since 2005 a modified lipoabdominoplasty has been performed in selected cases, modifications are transverse elliptical plication across the lower abdominal wall, no detachment of the flap above the umbilicus, unrestricted liposuction of the abdominal flap including midline, flanks, and epigastrium; direct resection of skin and fat in the lower abdomen from the navel to the pubis and from an anterior iliac crest to the other; umbilicus amputation and immediate reconstruction in the ideal position with a skin graft, and low transverse scar placement (TULUA). It is believed that TULUA has advantages in terms of vascular safety, recovery of sensitivity, position, and quality of the neo-umbilicus and location of the transversal scar, with normal or superior aesthetic results, which could expand the indications to a larger group of patients as obese, secondary cases, umbilical hernias, ventral hernias of the hypogastrium and those with massive weight loss due to bariatric surgery. During abdominoplasty, liposuction of the detached supraumbilical flap is not recommended because of its vascular impairment and the possibility of skin and fat necrosis [1].