My fascination with, and what drew me into plastic surgery was the concept that there were many good solutions to any particular problem. In this instance, there is no ‘correct’ answer, merely philosophical differences in one’s approach. I have found that due to the excessive swelling during surgery, ability to for maximal skin excision is limited when significant liposuction is performed simultaneously. Staging the procedures allows for the swelling from liposuction to subside so that more skin can be removed during the final stage. This may seem like an extra step, but the quality of the incision and the final shape is superior when done in this fashion.