54 year old female who underwent gastric bypass surgery in 2005 and subsequently lost over 175 pounds. At the time of her consult, the patient stated she had a problem with the large and heavy abdominal pannus. She also suffered from rashes of the lower skin below the abdomen. She underwent a panniculectomy August 2019 and a total of 4,104 grams of skin and tissue were removed from her abdomen (9lbs). Since her surgery, the patient has lost 20 pounds and continues to follow a daily exercise regimen.