In a recent article for Refinery29, Elna Baker shared her personal experience with extreme weight loss and the mental and physical impact it had on her. Baker was overweight most of her life and, at her heaviest, weighed 265 pounds. By her mid-20s she had enough and lost 110 pounds. After she accomplished something she “never thought was possible” Baker was still unhappy, but for a completely different reason: her skin. It sagged from her now-thin frame and no matter how she tried to tuck it away or make it vanish with lotions and exercise, it still sagged. “The Before and After pictures you see on billboards—they’re a lie,” Baker says. “After dropping my weight, I had so much extra skin that I could lay on my side and pull it a half-foot in either direction.”

Baker would have four surgeries to remove the excess skin and turn her into the person she wanted to see in the “After” picture. She got implants the size of her old breasts and a body lift. Two years later, she went in for a circumferential body lift. “They made an incision around my entire waist, cut out a 6-inch belt of skin, and then sewed me back together, removing ten pounds of skin altogether… Now I have a scar that runs completely around my waist, as if a magician cut me in half.”

Here’s how Baker looked after the surgery: