After massive weight loss, skin redundancy remains an aesthetic and a functional problem that remains amenable only by surgical excision. Lower body deformities are the most troublesome for most patients. Aim of wok: To study and implement the different surgical treatment options for the management of the various lower body deformities. Patients and methods: 30 massive weight loss patients after they achieved their maximal weight loss as determined by the BMI that had been stable for at least 6 months prior to surgical interventions. Conclusion: management of lower truncal deformities with circumferential torsoplasty provides the optimum cosmetic result.