This is a 54 year old female. She is 5ft 4 inches and had a gastric bypass surgery done 3 years prior. She had lost approximately 125 pounds and had an abdominal pannus that caused her to have discomfort and skin irritation. She underwent a large Flor De Leis abdominoplasty where the incision is both vertical and horizontal. A plication of the abdominal wall was also performed to tighten her abdomen. The postoperative pictures are one year post op.