Abstract Background: Liposuction is one of the most commonly performed cosmetic procedures worldwide and is generally considered safe when performed by trained practitioners. However, severe structural complications involving the abdominal wall are rare and underreported. Case Presentation: We report the case of a 61-year-old female who developed a significant abdominal wall structural injury following abdominal liposuction. The patient presented with progressive abdominal wall weakness, contour deformity, and symptomatic herniation. Imaging studies revealed extensive loss of abdominal wall integrity, including disruption of muscular and fascial layers, resulting in a large abdominal wall hernia with denervation of the left side of the abdominal wall. The injury was attributed to liposuction performed in the incorrect plane between the abdominal wall muscle and fascia, rather than the subcutaneous adipose layer, causing iatrogenic damage to the abdominal wall architecture. Conclusion: This case highlights a rare but serious complication of liposuction, emphasizing the potential for profound abdominal wall injury and herniation if performed without adequate clinical skill and supervision. Awareness of this complication is essential for early diagnosis and timely intervention. Proper patient selection, adherence to safe surgical planes, and prompt evaluation of postoperative abdominal wall abnormalities are critical to preventing and managing such adverse outcomes.