64 year old requesting cosmetic enhancement of abdomen and treatment of a bulging abdominal wall. She has excess skin and stretch marks across the central abdomen. She has severe muscle laxity of the abdominal wall apparent on side view. She underwent full abdominoplasty with muscle tightening (rectus plication). The abdomen is flatter and tighter with greater definition of the hips and waist. The skin is tighter and near all of the stretch marks have been removed. The incision is hidden beneath the underwear line and the belly-button has a natural contour. The patient is shown 5 months after surgery.