This female patient lost nearly 130 pounds after her laparoscopic gastric sleeve procedure. This left her with a double lower abdominal apron of excess tissue and residual adiposity that caused skin ulcerations, rashes, and infections. She underwent a functional panniculectomy, or amputation of the lower abdominal tissues only. This was not a cosmetic operation or tummy tuck, and without liposuction nor undermining and advancement of her remaining abdominal tissues. She is seen here 2 months postoperatively.