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This 40-year-old woman presented to my office seeking improvement in the appearance of her abdomen following three cesarean deliveries. She was concerned about persistent excess lower abdominal skin and tissue that had not improved despite her efforts with exercise and weight loss. She also had an umbilical hernia for which she had previously discussed repair with a general surgeon. Together, we developed a combined approach to address both her abdominal wall reconstruction and aesthetic goals. At the time of her umbilical hernia repair, I performed an abdominoplasty with abdominal liposuction to remove excess skin and soft tissue, improve abdominal contour, and restore a more defined and aesthetically balanced abdominal profile.