This SNIP addresses the following questions: a) What are the risks of DVT and PE in massive weight loss patients? b) What nutritional issues can be optimized prior to surgery to ensure maximal wound healing? c) What criteria do insurance companies use to determine medical necessity for panniculectomy? d) When should a patient be counselled for a belt lipectomy versus an abdominoplasty? e) When is a Fleur-de-Lis Procedure preferred over an abdominoplasty?