This female patient lost over 200 pounds after her laparoscopic gastric sleeve procedure. This left her with double abdominal aprons 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. In order to correctly unfurl her upper zone of adherent skin and upper abdominal roll, a fleur-de-lis type resection was performed. This was not a cosmetic operation or tummy tuck, and without liposuction nor tightening of her remaining abdominal tissues. She is seen here 6 months postoperatively.