Extreme loss of weight, old age or pregnancy can result in surplus skin and fat, mainly in the lower abdomen (fat apron), the breasts, the inner sides of the upper arms and thighs and the buttocks. Liposuction alone is not always sufficient, as the skin does not completely return to its original state. An additional lifting operation is usually performed to restore shape. Incisions are usually made in the region normally hidden underneath underwear (bikini line incision) or are covered by the bra. On the upper arms and thighs, the incisions are made on the inner sides so that the scars are not noticeable. During this lifting operation, the removed body fat can be used to fill and thus augment flat or sagging buttocks or hanging breasts.