As a former New Yorker, I would like to answer your question as best I can.
If the score is 4 to 1 FOR the procedure, I THINK you already have at least a partial answer. It does not mean you original surgeon is necessarily "lazy" but it does mean that his vision / experience is not shared by the other 80% of the surgeons who had the opportunity to examine you.
I have a significant experience in body contouring surgery and in examining my results, I have increasingly seen that a lot of abdominoplasty patients GREATLY benefit and have MUCH BETTER results from back liposuction done in conjunction with a tummy tuck.
As the tummy is tightened, your waist will be narrowed narrowed. But, if you have a significant amount of fat on your low back / upper buttocks, that fat would now look exaggerated since the waist just above it will be narrowed. Liposuction on the other hand defines the upper buttocks and lower back IN THE RIGHT PEOPLE.
Lastly, on a personal note, if you really ARE "Scared2death" and think that 80% of the plastic surgeons you saw are "just trying to rip you off" MAYBE you should NOT be having surgery. After all, this IS " I WANT surgery" not "I NEED surgery" and something bad MAY happen to you and validate your worst fear. I am by NO MEANS saying it will happen, but if your inner voice tells you NOT to do it, you should listen to it and not do it.
I hope this was helpful.