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    1.In some patients the formal abdominiplasty is sometimes will not suffice,they also want the excessive skin on the back of the waist to be removed and at the same time they want their thighs to be lifted
    2.This operation is the combination of a formal abdominoplasty with removal skin around the entire waistline, and can include lifting of skin of the lateral thighs
    3.It can even be used to lift the buttocks if continued all the way around the back.
    4.It is most useful for patients who have had a considerable weight loss.
    5.It is also used for patients who have had bariatric surgery, where there is sagging of the skin of the entire abdomen both in the front and the flanks
    6.It is a major procedure and may require intensive care facility for a few days

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