56 year old female who underwent gastric bypass surgery in 2007 as well as a revision in 2015. She subsequently lost 70 pounds. At the time of her consult in 2017, the patient had a large abdominal panniculus that hung over the suprapubic area. She suffered from skin rashes and intense itching under the skin fold beneath the panniculus. She also complained of neck and back pain. She underwent a panniculectomy in 2018 and a total of 7584 grams of skin and tissue was removed from her abdomen (17lbs).