Options limited so get several opinions

First, let me say that in general the question of how to tighten skin without surgery, especially when there are stretch marks, has not been truly solved. Many propose laser-assisted liposuction procedures with claims of skin tightening, but this is surgery and the concept of skin tightening with laser-lipo (for example, cool lipo) has not been objectively proven. What has been reported in the medical literature does not support claims that it is any better than liposuction using traditional techniques.

You may wish to look into Thermage, or liposuction + Thermage.  Last year I participated in a clinical trial in which we proved, with objective measurements, that there is more skin tightening of the abdomen with lipo immediately followed by Thermage. Often, it can be done under local anesthesia, so it is pretty minimal as far as surgery goes.

Most of the time, though, if there is a lot of laxity in the skin, a tummy tuck is going to give the best result by far. There is no such thing as a "nonsurgical tummy tuck" so as I said, shop around before making a decision.

Most women who have been pregnant not only have stretched loose skin and stretch marks but also laxity of the abdominal wall muscles-- simply put, nothing can correct this without an operation, and this muscle laxity is often the major issue.

In addition, I would be very careful trusting any nonsurgical modality that promises to tighten your skin with stretch marks. I would ask to see LOTS of before and after photos and personally talk to patients who have had the procedure. Be careful and invest your hard earned money wisely.

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I have an extremely busy practice and see many post-pregnency patients who don't like their abdomens - many just like what you describe!  With extensive stretch marks, your skin has lost all ability to shrink any more than it already has regardless of any non-surgical treatments you do. 

In my experience, virtually all patients like yourself want the flattest, tightest abdomen they can have and this only comes from a tummy tuck.  Just budget for it, don't waste your money on non-surgical treatments and find the best plastic surgeon for the operation and aftercare.

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