Abdominoplasty is one of the few cosmetic procedures performed in the UK on the National Health Service (NHS). In the current climate of tight resource rationing many primary care trusts (PCTs) are refusing to fund such operations, resulting in a number being carried out in the independent sector. There are very few studies in the literature on patient satisfaction following abdominoplasty, with none from the UK. Our study aimed to look at the patient satisfaction rate following abdominoplasty in the NHS and study further the areas of dissatisfaction. A questionnaire survey was sent to 153 patients who underwent the procedure over a 5-year period. Replies were received from 118 (78%) patients, revealing a 77% satisfaction rate amongst responders. Further analysis of the dissatisfied patients revealed particular dissatisfaction with dog-ears, residual abdominal overhang and issues relating to the scar. The dissatisfied group was exclusively female from across the age spectrum, although analysis showed an increase in dissatisfaction with time, with the highest levels seen at 4-6 years post-abdominoplasty. This study has identified a number of areas of patient dissatisfaction, even in carefully selected patients.