This patient suffered from 3 abdominal wall hernias that had been repaired in the past but failed in part due to her weight and tobacco use. She underwent a gastric sleeve operation to lose over 90 pounds and quit smoking. Here she is looking amazing after a life changing transformation combining a lower abdominal panniculectomy with a tummy tuck, old mesh removal and repair of her large (17cm x13cm) hernia. She no longer feels like an “alien” is coming out of her belly, and she is back enjoying life in ways she hasn’t since she was a teenager. We are so happy for her.