61 year-old woman, 5’6”, 150 lbs., 2 children, with 40 year-old midline lower abdominal scar and right lower appendectomy scar wanted to have a smooth abdomen and remove excess skin and fat and remove the scars if possible. She is shown six weeks after tummy tuck, and vaser-assisted liposuction of the upper abdomen and waist. The adherence of the skin over the ribs was released with discontinuous undermining to redistribute the skin downward and minimize lateral upper abdominal bunching from skin excess, which can be problematic in such cases. After removing all the skin affected by scarring, the skin flap was re-attached with progressive tension and quilting sutures to firmly secure the skin flap back the abdominal wall. By doing this, all the potential space where fluid can accumulate is closed off, so no drains are needed and none were used. She had Exparel injected under the abdominal fascia during surgery to minimize post-operative discomfort, and the incision was meticulously closed and covered with Prineo dermabond tape. Prineo seals the incision, is antibacterial, and is all the dressing needed after the first few days.