Here we have a pleasant 43 year old lady from Scottsdale, Arizona who desired tighter arms and youthful looking breasts. She consulted with me at my Scottsdale, Arizona plastic surgery center. At the time of her consult she told that she had gastric bypass surgery 7 years ago and managed to lose over 130 pounds. She has kept the weight off and is now much healthier, but she did not like her arms and breasts. She sat down with me and discussed her wishes. She mentioned that her goal was to find a plastic surgeon that would provide her with good results, but natural plastic surgery results. She liked my technique for arm lift and breast implant placement. She mentioned she had always been a DD before the weight loss, but was now wearing a B cup. She wanted me to return her breasts to a DD without a breast lift. She decided on a combined cosmetic surgery procedure. She decided on the posterior arm tuck technique that hides the scar in the back of the arm. This arm lift technique also removes excess skin in the arm pit region, a procedure called axillaplasty. She also decided on a little bit of lipo in the upper back. She also had a breast augmentation using 650 cc moderate plus saline filled implants with a dual plane technique. She is shown 8 weeks after cosmetic surgery on her before and after photographs.