Thank you for your question regarding what procedures would be ideal after significant weight loss. Thank you for your history, and thank you for your pictures. Congratulations on your weight loss. Based on your history and limited pictures, I would suggest an extended tummy tuck and thigh reduction. These procedures can be combined. The extended tummy tuck would address the abdomen, pubic region, and hips. If your buttocks bother you, the extended abdominoplasty or tummy tuck can be converted into a 360 circumferential lower body lift. Some plastic surgeons also call this a belt lipectomy. This would address the abdomen, pubic region, hips, and buttocks. I would also suggest a thigh reduction. This would include thigh liposuction on the anterior medial portions of the thigh and excision of skin and fat from the groin to the knee. The incision is placed on the inseam of the thigh so that when your legs are together, the incision is hidden. Cost estimates vary by practitioner and geographic location. Please contact multiple plastic surgeons to determine the cost. Regarding the abdomen, I am not sure why you would not want muscle repair. Your profile picture shows that the rectus muscle is extended above the umbilicus. Rectus plication or muscle repair would correct this extended abdomen. In my opinion, I would strongly advise you have muscle repair. However, in the end, it is always your decision. Consequently, muscle repair would give you a much better result. I hope these answers help to clarify your question regarding what procedures would be ideal after massive weight loss. I specialize in reconstructive plastic surgery after weight loss. Because a main focus of my practice is weight loss, I have a full time Registered Dietitian, Nutritionist, and diet coach. As a medically certified team, we help patients to permanently lose weight. We offer an extensive comprehensive, weight loss program from one-on-one medically supervised diet and exercise plans, to prescription medications, and even weight loss surgeries. If you have any more questions regarding weight loss, please contact my office. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)