Hello and thank you for your question. The best advice you can receive is from an in-person consultation. If you have excess back fat, back liposuction can be performed at the same time. If you are an appropriate candidate for a tummy tuck, this can be done through a low and short incision, all completely below the bikini line. The belly button can be designed to look natural and have no scars on the exterior. Your muscles can also be plicated resulting in a flat abdomen. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person. Best wishes and good luck. Richard G. Reish, M.D. Harvard-trained plastic surgeon