You bring up several issues that are important to address. The first one is men who are critical of spouses and pregnancy related changes. Life would be more fair if men would take a physical hit for the privilege of having children as well but unfortunately, this is all up to you women despite modern political trends. In regards to your abdomen, it’s important to differentiate what the underlying causes are of way an abdomen looks the way it does. There are four tissue variables that determine what the abdomen looks like. In other words if somebody doesn’t all alike the way their belly looks it is always because of one or more of four different tissue variables. Understanding which of these tissue variables is primary, secondary tertiary, etc. helps determine what the correct procedure is. The four variables to determine what the abdomen looks like our abdominal skin laxity generally related to previous pregnancies or significant weight loss, excess subcutaneous, fat layers, muscle separation from previous pregnancies and excess visceral or intra-abdominal fat. It’s important to note that pregnancies do not change fat distribution. Of the Ford variables to a related to previous pregnancies, and those are abdominal scan, Laxcity and muscle separation. Both of those variables are best treated with a full tummy tuck. Having children does not change your fat distribution. For this reason, Liposuction is not often the best treatment for pregnancy related changes. If you specifically want to return your body to the way, it looked prepregnancy. The Liposuction is not going to do that. That doesn’t mean you have to have a tummy tuck and it doesn’t mean you can’t have Liposuction. It’s simply means that Liposuction is not going to reverse the changes that came from pregnancy. To differentiate each variable, you can try the following. Try pulling your skin tight to see if it changes your abdominal contour. That will tell you the impact of skin laxity. Based on your pictures, it doesn’t look like skin laxity is a big component, but most women will get stretched a bit from having multiple pregnancies. To get an accurate assessment of the thickness of your subcutaneous fat layer gently take the tip of your finger and press against your skin until you feel the underlying muscle wall. It takes a very little pressure and you can try doing it over your ribs to get an idea and then try it along different areas of your abdomen. I’m guessing your subcutaneous fat layer is about 1/2 to 3/4 of an inch thick. well done Liposuction can remove 50 to 75% of your subcutaneous fat layer. In reality this means your abdomen will come in by about half an inch. It may be a little more but it’s not enough to get you a flat abdomen the way you had pre-pregnancy. A straight muscle wall should create a beeline between your sternum and your pubic bone. You can feel your muscle while and see if it bulges out significantly in front of this fictitious line which it appears to do in your pictures. There’s no way to treat muscle separation without a full tummy tuck. I don’t think you have an issue with visceral fat. Visceral fat presents very similarly to muscle separation. It causes the abdominal muscle wall to bulge. The easiest way to differentiate muscle separation from visceral fat is to see what your abdomen looks like when you lay on your back. If it goes completely flat when you lay on your back relaxed than visceral fat is not contributing significantly. If it’s still bulges, when you’re laying on your back and visceral fat is a significant components.Visceral fat can only be lost through weight loss. As I mentioned earlier, I don’t think visceral fat is an issue in your case. I think you have mild to moderate skin, Laxcity and moderate muscle seperation, which are typical for having had a few children and young healthy women. Liposuction it will reduce your subcutaneous fat layer, but would not address the muscle separation, which is causing your abdominal wall to bulge. Whether a full tummy tuck is appropriate or should be considered it’s something you’ll have to think about and discuss during in person consultations with local board-certified plastic surgeons. Simply recognize that pregnancies do not change fat distribution, and Liposuction treats, subcutaneous fat. You mentioned you want a BBL but you did not include any pictures of your bottom, so we can’t begin to make an assessment regarding having a BBL. Fat transfer procedures are always two operations done at the same time. Fat transfer requires harvesting fat and that is done with Liposuction, so anybody who has fat transfer is going to have liposuction in conjunction. Delivering consistent quality, Liposuction, and fat transfer results is more difficult than most people believe. The number of plastic surgeons who actually mastered these procedures is relatively few and patients should be far more selective than they ever thought necessary when it comes to choosing providers for both Liposuction and fat transfer. Poorly done Liposuction can leave people disfigured incorrect in poorly done procedures. It’s very difficult and often not possible. Do not assume that the fact that somebody is board-certified and plastic surgery, as years of experience, or has a good reputation has anything to do with Liposuction skills or fat, grafting talent. Most plastic surgeons think they’re better at Liposuction and they actually are. The number of providers who have mastered of these procedures are in a relatively small minority I need to be found. The best way to find the right provider if they have multiple in person consultations. The more consultations, you have the more likely you are to find the best provider. Considering how a few plastic surgeons are really excellent at Liposuction and fat transfer I recommend patient start by having at least five in person, consultations, but consider scheduling more, unless they feel very confident that they found one of the best providers. I recognize this is time consuming, especially for people who have busy lives raising children. You’ll be reminded of the outcome every day for the rest of your life. There is enough bad work being done, including people being left disfigured permanently from these procedures, that patients should take the decision far more seriously than most people do. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics to your own. An experienced provider should have no difficulty showing you the before and after picture of at least 50 previous patients. Being shown a handful of pre-selected images, representing the best results of a provider’s career is completely insufficient to get a clear understanding of what average results look like in the hands of each provider or how many of these procedures they have done. Do not make any assumptions about somebody having mastered any single procedure, regardless of their overall reputation success Long, waiting, lines fees, charged, or any other variable. The best way to understand the skill and experience of a provider is to look through their entire collection of before and after pictures. Providers may be apprehensive to show you anything but their best pictures so you need to as a consumer insist on seeing sufficient verification of quality work to be convinced that the provider has what it takes to deliver quality work. As I mentioned earlier, in my view, that is a minimum of 50 previous patients. Reviewing before, and after pictures with a true master, is a bit like reading a telephone book. You could literally spent hours just looking at impressive pictures. The biggest tip off for not selecting a provider is an insufficient number of quality before and after pictures. Obviously, Young providers will have less experience, and therefore have less before and after pictures. Recognize that it takes decades to master your skill, but time abd experience is not enough to master, liposuction and fat transfer. If someone does not inherently, have the skill or desire to master the procedure. A substantial number of plastic surgeons do not take Liposuction seriously and will never be good at it. You appear to be a good candidate for different procedures. The most important variables are always patient candidacy and the skill of the provider. There isn’t much at this point you can do to change your candidacy, so focus all your efforts on finding the best provider. Nobody hast to have a cosmetic surgery. When in doubt, slow down and schedule more consultations. Best, Mats Hagstrom, MD