From your description, it really sounds like you have a fair amount of excess skin and stretch marks. In general, this is really only best handled with an abdominoplasty, or tummy tuck. This procedure uses a long incision placed low in the panty line to get rid of excess skin and tighten the underlying muscles to improve core posture. Some urologists I have spoken to feel that it even helps some patients improve their stress urinary incontinence. I will often combine this with love handle liposuction to improve the overall figure. We will also often use IPL lasers to decrease the redness in pregnancy associated stretch marks to help them fade better. Occasionally, I will even perform breast rejuvenation to get that "before baby" look restored. In your situation, breast augmentation (with or without mastopexy (lift)) may worsen your back symptoms and a proper consultation with a board-certified plastic surgery can help you figure that out.
I hope this helps you.
Dr. Shah
