Background: Gender dependent outcomes in the surgical patient have been documented in the bariatric, trauma, and critical care/infectious disease literature. Body contouring surgery is technically demanding and a significant physiologic stress on the massive weight loss patient. Little is known about the effects of gender in this population Method: Data was collected prospectively on all body contouring patients and their operations by a single surgeon (JPR) over a 4 year time period. Patient variables that were collected included: comorbid conditions, preoperative BMI, maximal BMI, age, and gender. Outcomes assessed included: operative time, deep venous thrombosis, pulmonary embolism, seroma, hematoma, surgical site infection, dehiscence, transfusion, and reoperation. Chi square analysis was utilized for dichotomous variables and Student's t-test for continous data. Significant factors were then evaluated using a binary logistic regression. Statistical significance was assigned if p values <0.05. SPSS statistical software was utilized for data anlaysis. Results: Over the 4 year time period, 435 women and 48 men (8.9%) underwent body contouring surgery. The overall incidence of hematoma and seroma formation was 4.1% and 14.3%, respectively. Male gender was associated with an increased risk of hematoma (6/48, OR 4.22, p<0.05) and seroma formation (12/48, OR 2.15, p<0.05). However, male gender was not an independent predictor of wound dehiscence, flap loss, transfusion, or surgical site infection. Furthermore, while men were more likely to develop hematoma and seroma, this was not associated with an increased incidence of reoperation. Conclusion: There are differences in surgical outcomes based on gender in the body contouring population. Males are at an increased risk of hematoma and seroma formation. These differences require further study.