52 yo massive weight loss patient is shown before and 5 months after an "extended abdominoplasty".  She is 5'5" and 175 lbs,   In addition to having 2 children, she has lost 107 lbs with weight watchers and exercise. A standard abdominoplasty would have left her still with significant laxity (looseness) of her skin on the sides.  She could be considered a candidate for a traditional lower body lift, but an extended abdominoplasty, which extends the incision back nearly as far as we can without repositioning the patient on her stomach, gives her much of the improvement with much less expense, less risk and an easier recovery.  And she can always return to complete the posterior half of the lower body lift at a later date if she desires.  At 5 months, her scar is still quite red, but will typically fade and improve over a 2 year period.  And the scar is positioned to be hidden by most clothing styles.  To further tighten the slight looseness of the skin in the upper abdomen just below her bra line she would need an additional vertical ( up and down) excision of skin above her umbilicus (belly button) which would leave a visible scar that would not be hidden by a two piece bathing suit.