Former US gymnastics doctor Larry Nassar has apologised to his victims as he had at least another 40 years added to the jail sentences he is currently serving.
Nassar, 54, had pleaded guilty to sexually abusing girls when they sought treatment for injuries at Twistars, a gymnastics club in Michigan.
The disgraced doctor was already going to spend the rest of his life in jail for two previous sentences: Between 40 and 175 years on a separate but related case in a different county, as well as 60 years in federal prison for child abuse images.
Today's sentence – which was for 40 to 125 years – is his final criminal punishment for offending that saw him prey on more than 260 women, with some of the abuse occurring decades ago.
In his own statement, which lasted less than a minute, Nassar tried to apologise to the women, saying: "It is impossible to convey the breadth and depth of how sorry I am to each and every one."
He added: "The words expressed by everyone that has spoken, including the parents, have impacted me to my innermost core."
For two days, the court in Charlotte had heard from dozens of victims who had been "robbed" of "one of the most truly important human qualities – trust", according to Eaton County Circuit Judge Janice Cunningham.
At Monday's sentencing, Assistant Attorney General Angela Povilaitis said that Nassar had been believed by authorities for years, adding: "Each time he got away, he was empowered to continue and perfect his abuse".
Several of Nassar's victims were in the courtroom and cried as he was sentenced.
Rachael Denhollander, the first to make her allegations of abuse public, smiled and squeezed her husband's hand.
After Nassar was led out of the courtroom in handcuffs, victims lined up to hug and thank her.
In her victim statement she had asked: "How much is a little girl worth?"
After the sentencing, she told Reuters news agency: "I got my answer."
"It's worth the fullest extent of punishment justice can provide. That's what just happened here."
On Friday last week, the hearing had been suspended after the father of three of Nassar's victims had lunged at him in court.
Randall Margraves tried to attack the abuser after two of his daughters, Madison and Lauren, gave evidence.
He asked the judge for "five minutes in a locked room with this demon", but she refused.
Nassar had been a high-profile sports medicine doctor at Michigan State and USA Gymnastics, the sports governing body, and the scandal has prompted a number of resignations at both.