This patient comes to me with diet resistant fat and loose skin of the abdomen. This is complicated by her old cholecystectomy scar. I recognized that an aggressive approach would result in skin death, so I had to be modest in my release of tissue. An extensive plication was performed through a narrow tunnel. Liposuction was performed as well, but undermining was kept to a minimum. About 1500cc of fat was obtained from abdomen and flanks. Her recovery was uneventful and she is pleased with the outcome. The limited undermining necessitated a cautious resection of skin, so the umbilical donor site was closed in a vertical manner.