At 57, this patient presented after a remarkable weight loss of over 200 pounds, seeking relief from a grade 3 pannus that was significantly interfering with her quality of life. Despite her incredible achievement, excess skin, abdominal muscle separation (diastasis), and descended flanks limited her comfort and daily activities. Dr. Georgina Nichols performed an extended abdominoplasty combined with a monsplasty to remove excess skin, repair the abdominal wall, and lift and reshape the flanks. The result was both functional and aesthetic—improved core support, enhanced mobility, and a more defined, harmonious silhouette. This case highlights the importance of addressing excess skin after massive weight loss and how body contouring surgery can dramatically improve quality of life, comfort, and confidence.