Abdominal contour deformities pose an aesthetic challenge to patients with massive weight loss. This article reviews the similarities and differences in obesity between the Asian and Western populations. A comprehensive classification system combining the objective description of structural deformities with patients' discomfort or physical function is required to classify the abdominal contour deformities. The authors also proposed several controversial issues, including the classification of abdominal deformities, surgical techniques, and complications, providing an evidence-based review for selecting the appropriate surgical method for Asian patients to achieve satisfying clinical outcomes and avoid complications.