This 46 year old mother of two who had been overweight her entire life, until she had a gastric bypass about two years before surgery. She managed to lose almost half her weight, from 320 pounds to 167 pounds! But that left her with a great deal of loose skin.
She had an arm lift to tighten up both upper arms. At the same time, she had a breast augmentation mastopexy (breast lift / breast augmentation)