 Good morning, everyone. Happy Friday to everyone. I hope you guys are all getting for a nice hot, hot weekend. Stay cool. Let's start the journey of this beautiful young lady. She's in her thirties. She's a mom. Three kids. Better yet, she's lost 40 pounds, believe it or not. So today we're gonna start her journey to a new body, summer 2021. So let's take a look at what we're gonna do for this beautiful lady. First of all, I have her color in every color possible. We'll go over some things. It's good. This is a very good learning case. Good mommy makeover and it's gonna be excellent result. Couple of things. Let's start from the top. You can see her shoulder is a little bit higher on the left and that's normal. No one is symmetrical. Look at the difference. It's about maybe a seven meter to a seven meter and a half difference. She's angulated in this direction. I have some ink on my fingers. And then let's go look at this. The width of this breast is 21 centimeters. This side is a little smaller at 19. You could see where the top of the new nipple is going to be. So what we're going to do is move the nipple area right here and the top of the area up here. So when we close it, when we close the organ, as I always like to say, it's going to end up with a breast like that and we're going to add fat to the top. We got it as symmetrical as possible. Remember they're not twins. They're sisters. The nipple from this side is going to be 12. Then this side is going to be 13. She has a little bit more volume on this side. I put the fold, I put the marking on the fold. We can see the fold is a little bit higher here than here. We'll try to adjust for the fold and you can see even the length of our thing I measured it's six, seven years of our width. The lift is one of the more complex things we do because they're two breasts. We're working with bone, soft tissue. There's a lot of movable parts and there's parts that aren't movable. So it's a pretty complex case. Then we get to the easy part. We're going to do a tattoo removal for her. We're going to get rid of her tattoo today. We're going to get her waist as small as possible. We measured it 45 and a half inches right here where her belly button is because the belly button is a stable place and it doesn't move because it's going to stop. So we're going to light her contour, cinch in her waistline, cinch in her pubic, and then remove all the excess skin. Lost 40 pounds. It's a lot of weight, but unfortunately another teaching point. Skin is not made out of muscle. So no matter how much weight you do, how much you exercise, the skin doesn't tighten because it's made out of collagen and elastin and our body stops producing collagen after 25 in our early 20s about 25 unless we provoke it. How do we provoke to make collagen? Either we're involved in an accident, we do lasers, we stimulate it somehow to open up the factory and make our body produce collagen. And let's have her turn around. So we're going to do the internal corset, tummy tuck, make sure her muscles are tight after three kids. And as she turns around and put the marking for her buttocks, we're going to cinch her in her waistline, get her as small as possible and again bring on the breast, the new nipple area over. She's going to have a nice lift like this and we're going to use her fat from here and put it up top to give her fullness. We don't need to use an implant. She has good tissue. We're just going to use some of her own fat and bring it where we want it to be. So this is going to be an excellent case. We're staying green. We're recycling. Stay tuned with us. Hi everyone. So we're starting with her breast first. This is what she looks like on the left. This is what we want the right side, the right side to look like. So we're going to move up the nipple area a lot. We're going to take out skin both in the vertical and horizontal shape. The horizontal vertical we're taking out skin this way. You could see how instead of just laying on her skin, it's going to be elevated. In addition, we're going to add some fat up here. So this is called tailor tacking. We use the staples before just to see what it looks like before we actually make a cut. You know where our motto is, measure twice, but we cut once. So we put the second one together too. You could see the origami is put together. Couple of things to take into account. You can see more projection here, but remember where working this side is only 19 centimeters. This side is 21. We can't cone it in more because then it'll give us a more cone shape rather than a nice breast shape. What we can do is add a little extra fat here. Just remember, I cannot change the bony difference. She has some scoliosis. This side of her chest measured 21 centimeters. This side 19. Somethings can't be changed. Bony stuff can't be changed. I could change fat. I could change skin, but not bone. So we're going to get started and we're going to put it all together. Stay tuned. We have these called the cookie cutters. We put it exactly around the areola so we get a nice circle. So we're going to go and cut the areola at this time. So we're going to do a low writing incision. You can see how laterally we come up so it pulls up and gives her a little bit of a thigh lift. So here we are. We start out lateral our incision and we go all the way across. All this skin is going to be coming out. So while you guys were at lunch, Dr. Saul and the gang, we were operating. So let's see what we've done. First, you know, she was big on the outside, but in reality her frame and skeleton is very small. I'll show you how small she is. Come over from this side. So what we did is we did a lower incision. We went all the way to the belly button. We went down all the way to the muscle. She looks great. Look, but look at her pelvic. Look at how small she is. This is her frame. All the rest was extra. How do you call it? Like cream on the cake, but we're down. This is their actual cake. The rest was just icing. We took out all the icing, so we're just going to have the cake. Look at how nice she's going to look. So what we're going to do now is tighten the muscle. You know what we do? Two layer, one interrupted, one continuous permanent suture. She's going to be as tight as a drum. Stay tuned. So you guys, here's the midline. Here's where the muscle is out right now. So you can see it's not huge, but she's opened up someone and we're going to put all this nicely together. And she's even going to be smaller. That's what happens when you see a very cinched-in waist line is that this is coming in. Once I pull this in, look at how much her it's going to come in. It's going to look fantabulous. So we're ready for the tattoo removal. There he is. He's going to be gone. Let's see. Here we are here. Here we're measured 13 inches of skin coming out in the vertical aspect. We got it ready to go. We're going to extend a little laterally. There we are a lateral. And then we're going to go up top. We're going to put attention. And here we go for the ride stop right there. Okay, everyone, we're done with the case. We did a breast lift. Look how beautiful they are. We did some fat transfer. We put some of the fat up top. We moved the areola and nipple up. We can't show you, but I'll show you the tattoo removal. There's the tattoo. We took it off fully. And look at this. Look at the length we took out is about, I guess it was about 13 inches. And going across was 28 inches. And watch this. Look at this beautiful. All the stretch marks gone. Not all of them, but most of them gone. And any belly button. And look at how beautiful she looks. It looks amazing. Fantabulous. We brought her cinched in her waistline. And she looks amazing.