A 50 year old lady from Phoenix, Arizona requested plastic surgery after major weight loss. She lost 130 pounds after undergoing gastric bypass surgery in 2008. Her weight has been very stable for the past 12 months and she desired an improvement in her thighs. Her highest recorded body mass index was 52.1. Before inner thigh lift surgery, her body mass index was 28.3. She was not happy with the excess skin of the thighs. She was also not happy these were deflated and flabby inner thighs, especially in the upper part of her thighs and her knees. She described a "ball" on her knees. She wanted an inner thigh lift with a horizontal and vertical component. We decided on plastic surgery after major weight loss, including inner thigh lift, arm lift and breast lift. I actually recommended a lower body lift first, but her priority was the arms and thighs, and so we did this operation first. Before surgery, she is 5 feet 2 inches and weighed 155 pounds. The weight of the tissue removed with thigh lift was over 7 pounds. She spent 3 nights after surgery at a local cosmetic surgery hospital. Her before and after photos show her at 12 months after inner thigh lift and outer thigh liposuction. While no outer thigh lift was performed, a drastic size reduction of the thighs has occurred even down to the knees.