The number of bariatric surgery procedures has been steadily increasing over the years. Plastic surgery can improve the quality of life in formerly obese patients with skin excess, causing poor hygiene, dermatitis, intertrigo, and skin infections. The timing for body contouring surgery is patient related. There are six major areas of the body that are amenable to surgical correction after MWL (massive weight loss): the abdomen and hips, breasts and chest, arms and axillae, back, thighs and face and neck. After massive weight loss, female breasts become deflated, and the profile may be severely distorted, with upper pole deficiency, high-grade ptosis, lowered inframammary fold, medialization of the nipple-areola complex (NAC), lateralization of the breast mound and breast tissue extending into the axilla. The changes seen in the male breast are similar. Traditional techniques are often inadequate because of poor tissue quality. To recreate the shape and to give volumes in the right proportions to these anatomical regions, local autologous pedicled flaps such as the AICAP (“Anterior Inter-Costal Artery Perforator”) flap can be considered in order to provide stability to certain anatomical districts, allowing for longer-lasting surgical results and consequently ensuring greater long term satisfaction. Each technique should take into account not only the patient’s characteristics, but also his or her goals. Often the combination of several patient-tailored surgical techniques allows for the achievement of an optimal result.