Mommy Makeover refers to a combination operation on the breasts and abdomen to improve the changes frequently seen after pregnancy. This month’s patient has an unusual presentation. She, in her twenties, had a breast reduction performed by another surgeon. She then had a pregnancy as well as weight loss. Now in her thirties, her breasts have skin changes and volume loss. She has a nice improvement with a breast augmentation which is not as straight forward as it might appear. Her pre op abdomen, while thin, has skin changes as well as muscular diastasis and laxity. Mini abdominoplasty ( not cutting around the umbilicus and limiting surgery to the lower 2/3 of the abdomen ) removes a surprising amount of excess skin ( as seen tissue specimen photo ) and flattens her profile nicely.