*Here is a 35 year old woman who had lost over 110 lbs after gastric bypass surgery. She now had excess skin on her abdomen. Her breasts, which had always been too large for her frame hadHere is a 35 year old woman who had lost over 110 lbs after gastric bypass surgery. She now had excess skin on her abdomen. Her breasts, which had always been too large for her frame, had lost some volume but were still too large for her and were now even more ptotic. This caused significant strain on her neck and back. To address her concerns a surgical plan was devised that included two separate outpatient surgeries. The first was a SPAIR breast reduction in which 590 gms of tissue was removed from her right breast and 580 gms from her left. The second surgery was performed three months after her breast reduction and consisted of an extended tummy tuck, meaning that the skin and resulting incision extended out around the sides of her abdomen to enable removing as much of the excess skin as possible. Her post-operative photos show her at five months out from her breast reduction and three months out from her tummy tuck. She has a very pretty aesthetic result but even as importantly has relief from her symptoms associated with the weight of excess skin and tissue lost some volume but were still too large and were now even more ptotic. This caused significant strain on her neck and back