Abdominoplasty has become a popular body-contouring procedure among patients with deformity resulting from massive weight loss. We present the results of a randomized controlled trial comparing the PlasmaJet® System (PJS) and conventional monopolar electrocautery for the treatment of the dissection surfaces in patients undergoing corrective abdominoplasty following massive weight loss. Sixty consecutive patients were randomized to undergo abdominoplasty either with conventional monopolar electrosurgery or PJS. The two groups were comparable regarding demographics, associated conditions, smoking habits, type and number of previous bariatric procedures, amount of lost weight, as well as previous abdominal scars. The primary end point was the rate of procedure-related postoperative complications and secondary end points were the time of wound drainage, total accumulated fluid drainage volume, the duration of hospital stay, and patients’ satisfaction. There were significantly less postoperative complications in the PJS group, namely wound infection (p < 0.05). There was no difference in the total amount of fluid output from the abdominal drains but the latter were retrieved 1 day before on average in the PJS group, and patients in the PJS group were discharged on average 1 day before patients in the control group. Overall, better cosmetic results were obtained in the PJS group (p < 0.05). Patients undergoing abdominoplasty with the PJS showed a lower rate of postoperative complications (p < 0.05), were discharged on average 1 day before patients in the control group and had better cosmetic results (p < 0.01).