The improvement of health-related quality of life (HRQoL) via post-bariatric tightening operations and their effects on long term weight stability is considered to be ensured. This study investigates the relevancy of influencing factors. For the data analysis, the HRQoL was ascertained before and after the abdominoplasty using the 36-Item Short-Form Health Survey questionnaire. In addition, the occurrence frequency of bloating-symptoms was recorded. It was checked whether this occurrence was related to a rectus plication simultaneously performed with the abdominoplasty. Inclusion criterion was obesity ≥ I° prior to the weight loss. Exclusion criteria were a postoperative, newly manifested and serious disease, as well as a pregnancy during the observation period. The results were compared to the German population (standard). The postoperative HRQoL was significantly improved as far as the physical healthscale (KSK) is concerned (preOP: 40,19 ± 12,27; postOP: 47,72 ± 9,89; p < 0,001). Preoperatively, the KSK and the PSK (psychological health scale) were statistically significant below the value of the normal population (KSK: p < 0,001; PSK: p < 0,01). There were no significant differences postoperatively (KSK: p = 0,051; PSK: p = 0,118). Patients on which an additional rectus plication was performed (n = 9) suffered significantly more often from bloating-symptoms than patients without this surgical step (n = 21) (p < 0,05). Patients with bloating-symptoms < 4/W (vs > 4/W) had a significantly better vitality (< 4/W: 61,09 ± 24,95; > 4/W: 34,29 ± 21,49; p < 0,05) and a better general health (< 4/W: 68,04 ± 23,23; > 4/W: 44,71 ± 27,8; p < 0,05). Compared to the standard, patients with bloating-symptoms > 4/W had a poorer vitality (p < 0,05). Based on the analysis, a postoperative improvement of the HRQoL in the formerly obese can be assumed. It can also be predicated that there is a postoperative adjustment of the HRQoL compared to that of the German population. Furthermore, a rectus plication that is performed in addition to the abdominoplasty more frequently leads to bloating-symptoms, which, in turn, worsen the HRQoL. The diagnosis of a depressive disorder is a good predictor for a worse HRQoL outcome.