Thank you for your sharing your photo and questions.
1. Judging from your photo, you may be a better candidate for a tummy tuck combined with liposuction rather than liposuction alone because you have a significant amount of extra skin. If you are not concerned about having loose, sagging, extra skin and are simply interested in debulking your midsection, then liposuction alone may be appropriate.
2. I would be certain to see an experienced provider (ie. Board Certified Plastic Surgeon) who performs both liposuction and tummy tucks for an evaluation. Be wary of the opinions of people who perform liposuction alone, as they will try to "sell" to you that their "laser" will "tighten" your loose skin, when in fact you are being misled. When all you have is a hammer, the whole world looks like a nail.
3. When it comes to performing liposuction, the SKILL and EXPERIENCE of the surgeon performing the liposuction is BY FAR the most important factor to consider. A good surgeon can produce excellent results with the right tools, including traditional liposuction, tumescent liposuction, laser liposuction, ultrasonic liposuction, etc. Personally, I prefer to perform laser liposuction as I believe it helps with skin tightening and recovery.
4. With regard to the latest in laser liposuction, ProLipo (Sciton) and SmartLipo (Cynosure) are both state-of-the-art technologies. Even more important than the machine itself, however, is who is using it and how.
I hope this helps.
Larry Fan, MD