Medical records of 122 patients who underwent an abdominoplasty or panniculectomy from 2003 to 2008 were reviewed to determine current rates of wound complications associated with these procedures in the presence of obesity. An additional aim was to determine current rates of complications as compared with those found 10 years ago at our institution to determine if the finding of obesity alone continues to adversely affect wound outcomes. Sixty-three of 122 patients (51.6%) experienced 1 or more wound-related complications. Major complications occurred in 13 patients (10.7%). A striking finding was that the lowest major complication rate 4.5%, was found in patients with extreme obesity (BMI >40). Comparisons between the 1999 and current studies found that the difference in major complications in those classified as obese, with 2 (9%) in the current study and 8 (40%) in the 1999 study, was significant (P = 0.039). Our findings suggest that high rates of major complications found in those with obesity in the 1999 study are not found today. Extreme obesity is not an absolute contraindication to operation and may be performed safely.