This patient lost a significant amount of weight and was left with loose, sagging skin in her abdomen as well as deflated breasts. She desired an improved breast shape and as much skin removal from her belly as possible. Dr. Geiger performed a breast augmentation with smooth round gummy bear implants (505 cc moderate plus profile) under the muscle in a dual plane approach. These were placed through incisions hidden in her breast folds for an outstanding size and shape for her frame. Dr. Geiger performed a fleur-de-lis abdominoplasty at the same operation, removing skin in both the horizontal and vertical directions. This maximizes the overall shape, and prevents any remaining loose skin from sagging off the abdominal wall when leaning forward. The trade off is a vertical scar on the abdomen but this will fade nicely over the next 6-12 months. Her fantastic shape is apparent right away.