34 year old requesting cosmetic enhancement of abdomen, trunk, and breasts after having 3 children. She has excess skin and stretch marks across the central and lower abdominal wall. She also has severe rectus diastasis (stretching of the muscle layer) which give a rounded look to her abdominal wall. She underwent full abdominoplasty with muscle tightening (rectus plication) with full breast reduction. The abdomen is flattened and tighter with greater definition of the hips and waist. The muscle layer was aggressively tightened eliminating the roundness. The skin is tighter and half of the stretch marks were removed. The incision is hidden beneath the underwear line and the belly-button has a natural shape. The patient is shown 6 months after surgery.