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Background: Online reviews increasingly influence patients’ decision-making. This is the first systematic, quantitative analysis of online reviews for abdominoplasty. Methods: Reviews for abdominoplasty were sampled from RealSelf, Yelp, and Google for six major metropolitan areas. A standard social sciences framework known as grounded theory was used to evaluate factors affecting satisfaction. The relative importance of factors was quantified using odds ratios. Results: Seven hundred ninety-four reviews met inclusion criteria. There was significant geographic variation with respect to number of reviews (p < 0.01) and average rating (p = 0.014). The authors identified 10 statistically significant themes affecting satisfaction. Of these, aesthetic outcome was the most mentioned theme [n = 368 (46.3 percent)] and the most dominant driver of satisfaction. Interactions with staff had the second highest odds ratio, driven by the fact that all negative staff interactions led to negative reviews. Postoperative care had the next highest odds ratio, and was demonstrated to counteract the negative effects of poor surgical outcomes on satisfaction. The occurrence of a surgical complication and the cost of surgery were least associated with satisfaction. Conclusions: This analysis is the first to use quantitative methods to identify dominant and nondominant factors affecting patient satisfaction in cosmetic surgery. The authors found that aesthetic outcome, staff interactions, and postoperative diligence were the most critical factors affecting satisfaction in abdominoplasty, whereas postoperative complications and cost were least important. Understanding the relative importance of factors may help to improve and protect one’s online reputation.