Beneath the surface: Incidental discovery of a large uterine fibroid during abdominoplasty

Abdominoplasty is a widely performed cosmetic surgical procedure after pregnancy that results in significant weight loss. Although this procedure is considered safe, surgeons must be prepared for unexpected intraoperative findings. We report the case of a 40-year-old asymptomatic female, in whom a large intrauterine fibroid was found incidentally during abdominoplasty. This is the first documented case of such findings. The mass was not explored further during the surgery. Postoperative imaging reveals a large intramural fibroid. Additionally, we reviewed the literature on incidental findings encountered during abdominoplasty. We discuss the potential gaps in routine preoperative evaluations and suggest a practical approach for managing unexpected surprises intraoperatively. This case report aims to support better surgical preparedness and follow a multidisciplinary approach in managing cosmetic surgery procedures.