BEFORE PHOTOGRAPH: This is a frontal view of a 33 year old woman who lost 100 pounds over a 10 month period with diet and exercise.  Most individuals who lose massive amounts of weight, with or without the assistance of surgery, have excess skin because there seems to be a limit to how much skin can shrink to a newer, smaller contour.  Every person's skin is different and some shrink significantly better than others.  This woman's skin shrank quite well, but she still had a small "flap" of skin that was folded over in the lower abdomen.  This is precisely what is addressed in abdominoplasty surgery.