Jeffrey Zwiren, MD

From your photo and description it appears that a full abdominoplasty would be recommended.  During a typical abdominoplasty a wide ellipse of skin and fat below the umbilicus is removed.  The incision for the abdominoplasty basically goes from hip to hip and would convert your vertical scar below the umbilicus to a low transverse one.  This low transverse incision will be designed to be well hidden below underwear or bathing suit bottoms.  The bulge that you are describing in the upper abdomen may be due to a separation of the abdominal muscles and can be repaired at the time of a standard abdominoplasty.  It is not uncommon to have combine other reasonable procedures with an abdominoplasty.   This operation will cause some restriction of movement and precautions must be taken to avoid blood clots in the legs.  Cost will vary.  It is not easy to give an estimate of cost without an examination.