This set of before and after photos features a 49 year old woman who lost 120 lbs through diet and exercise. This unfortunately left her with marked laxity of the breasts, abdomen, thighs, back and arms. After careful discussion and a review of all options, the patient decided to correct these issues with 4 procedures: An abdominoplasty (tummy tuck) to correct the abdomen and lower back; an extended augmentation mastopexy to raise the nipple areola and create superior fill to the breast; a back lift to remove excess skin from the sub axillary (bra line below armpit) and upper back regions; and lastly, a brachioplasty (arm lift) to reshape and tighten the under portion of the upper arm, from the underarm region to the elbow. Photos taken 4 months after surgery show dramatic improvement. The patient's waist/midsection is now tight, well-shaped and in proportion/sync with her upper body. She no longer suffers from excessive or hanging skin tissue, particularly in the upper back region. Her breasts are elevated and firm. Her skin envelope correctly accounts for her major weight loss. And the post-op scarring, which will continue to improve, is very acceptable.