Congratulations on your incredible 80+ pound weight loss and your dedication to maintaining it for six years! That’s an amazing achievement. Based on your photos and description, you have excellent options for addressing the excess skin and achieving your aesthetic goals. If the excess skin on your hips and buttocks bothers you, a 360 body lift would be a fantastic choice. This procedure removes excess skin and fat all the way around your midsection, addressing the front, sides, and back. It not only improves the abdomen but also lifts the buttocks and tightens the hips, giving a comprehensive transformation. For patients with significant skin laxity in these areas, the 360 body lift offers truly life-changing results. However, if the buttocks are not a concern and your focus is primarily on the abdomen and waist, I would recommend an extended tummy tuck. This procedure would address the loose skin and provide muscle repair (if needed) while contouring the flanks. You’ll still get a beautifully sculpted result, but with less extensive surgery than a full 360 body lift. No matter which procedure you choose, with your weight loss and fitness efforts, you’re going to see amazing results. I recommend consulting with a board-certified plastic surgeon who can discuss your goals in detail and help create a customized surgical plan that fits your needs. Sincerely, Dr. Katzen