Thank you for your question about the extra skin after your weight loss RNY surgery. Thank you for attaching pictures. I would suggest a 360 circumferential lower body lift. This includes an abdominoplasty (tummy tuck), pubic lift, pubic reduction, hip lift, hip reduction, and removal of excess buttocks skin. It will eliminate the wrinkles on the buttocks and lift and contour the outer hips. I would also suggest a longitudinal vertical medial thigh lift where the incision goes from the groin to the knee to eliminate excess inner thigh skin and fat. I would also recommend an arm lift from the elbow to the armpit. This should also be combined with a vertical torsoplasty with an incision from the armpit slightly down your sides to the top of the bra strap line. You did not include pictures of the breast, so I will not comment on breast procedures. However, after weight loss procedures, many patients require a breast lift (mastopexy) and breast augmentation with implants. Many of these procedures can be combined or staged. This depends on your plastic surgeon's comfort level and other factors. Please find a board-certified plastic surgeon before you embark on these procedures. You could be able to combine the lower body with the thighs. You could also do the circumferential body lift with the arms. I would counsel doing the arms and the thighs at the same time because the recovery is difficult. Because all four extremities will have bandages. I hope my answers help to clarify what surgeries to undergo after RNY weight loss. I specialize in reconstructive plastic surgery after weight loss. If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the lower body lift. Do your research. Make sure they have performed at least 100 circumferential lower body lift surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced, lower body lift surgeon in your neighborhood, consider traveling out of state if you must. 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.)