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This 49-year-old woman presented to my office seeking improvement in the appearance of her abdomen due to stubborn abdominal fullness and excess tissue. Following two cesarean deliveries, she found it difficult to eliminate remaining abdominal skin and tissue despite maintaining a rigorous diet and exercise routine. Together, we developed a surgical plan for an abdominoplasty to remove excess skin and soft tissue, repair and tighten the rectus abdominis ("six-pack") muscles, and restore a more contoured abdominal profile. The procedure was complemented with liposuction of the flanks to further enhance her overall shape. She recovered wonderfully and was very pleased with her results.