An ostomy appliance may include a wafer base plate to be coupled to a stoma of a patient and having a base layer with an opening positioned inwardly adjacent edges of the base layer, and first fastening pads carried by the base layer. The ostomy appliance may include an ostomy bag assembly to be coupled to the wafer base plate and having a bag with an opening to receive waste from the stoma of the patient, the opening being positioned inwardly from adjacent edges of the bag, and second fastening pads carried by the bag and configured to couple to the first fastening pads so that corresponding portions of the bag are retained against adjacent portions of the wafer base plate as the bag fills with the waste.
