It sound like you are taking all the steps one can to combat your situation. However, genetics not only plays a role in fat storage it wins!
You may be storing a fair amount of fat intra-abdominaly. This will not change with surgery. The surgical removal of skin and the fat attached will make a positive change. In addition tightening the abdominal rectus muscle combined with liposuction in the flank area will make a nice change, judging from your photo.
The best thing to do is get a consult from a board certified plastic surgeon and get information more specific to you.
Good Luck!


