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Background: Lower body contouring after massive weight loss exhibits a great challenge for the plastic surgeon. Aim of the work: is to assess surgical outcomes of lower body contouring after massive weight loss. Methods: This prospective cohort study was conducted at Plastic Surgery Unit, General Surgery Department, Faculty of Medicine, Zagazig University Hospitals on ten patients who underwent lower body contouring after massive weight loss. Full medical assessment, scar placement and meticulous marking, surgical procedure and post-operative care. Results: The mean of patient satisfaction on a scale from zero to 10 was 9 ± 1.26, most of operated cases had no complications (70 %), and there was significant positive correlation between lipoaspirate amount and hospital stay. Conclusions: Lower body contouring is an extremely effective procedure to restore body contour in post bariatric patients. Careful preoperative marking, team work and few surgical tips are the keys for a procedure that is both satisfactory for the surgeon and safe for the patient. [ABSTRACT FROM AUTHOR]