CASE DESCRIPTION: This is a 65-year-old resident of San Rafael, California who presented to the Novato office in Marin County for evaluation for an arm lift. She has lost fifty pounds by diet and exercise. She has undergone multiple surgical procedures. She has undergone an arm lift, multiple areas of liposuction, a tummy tuck, breast lift, and later a complete facelift. All of her procedures were performed at Marin Cosmetic Surgery Center in Marin County, California.