A pleasant 56-year old lady from Phoenix, is shown after requesting plastic surgery for major weight loss. She lost 120 pounds after gastric bypass surgery 25 years ago and had a tummy tuck performed in 1999. She was not happy with the results of her tummy tuck because she still had loose skin while the muscles were not tightened, showing a "pooch". At her consult in my plastic surgery office in Scottsdale, Arizona she told me her desire for a lower body lift, arm lift and thigh lift to be performed in a single surgery. She mentioned that after the weight loss, she developed loose skin, a flabby tummy, saggy thighs and loose arm skin. All of this really bothered her. She wanted to improve her figure. I sat with her and discussed her options. We decided on combined plastic surgery after major weight loss. I recommended a bodylift with a vertical extension to remove all the signs of her previously performed tummy tuck and tighten the central body as best as possible. I recommended a posterior arm lift to remove the excess and loose skin of the arms. I also recommended an extended inner thigh lift to reduce the cellulite in the inner and outer thighs. Before surgery, she is 5 feet 2 inches and weighed 130 pounds. A preoperative protein supplementation diet and bariatric vitamins was started. She spent 3 nights at a local Arizona plastic surgery specialty hospital, with a pain reducing pump, and experienced a smooth recovery. Her before and after photos show her at 8 weeks after vertically extended lower bodylift, posterior arm lift, and inner thigh lift.