This patient lost over 225 pounds after his duodenal switch procedure 5 years prior. This left him with a lower abdominal apron of excess tissue and residual adiposity that caused skin ulcerations, rashes, and infections. He underwent a functional panniculectomy, or amputation of the lower abdominal tissues. He added on additional resection with a concurrent lower body lift to provide circumferential removal of truncal excess. Nearly 11 pounds of tissue was removed in one procedure! Here he is ~ 4 months out from surgery. His scars will lighten and fade significantly over the next year, but will remain hidden in usual undergarments.