52, female, lipo 360 April 2023, revision December, is it loose skin or fat? (Photos)

Thank you for your question. Based on the picture you appear to be good candidate for Full Tummy Tuck with muscle repair to correct the sagging skin excess and abdominal weakness, also a belly, waist, flanks, upper and lower back Intense liposuction to remove the fat and if you are interested we can take the fat we get and transfer to the buttocks and hips, to mold them and get better volume, contour and butt projection, is that we know as "Brazilian Butt Lift" (BBL).

An in person evaluation is best, but from the photos it appears your contour is influenced by three factors. One is loose skin, another is some subcutaneous fat, and third is visceral fat. Liposuction only addresses subcutaneous fat. Visceral fat is located behind the muscle wall and is addressed through weight loss. The excess skin could be addressed with a tummy tuck. I've included a video I hope you find helpful.

You have some excess skin and prominent abdominal muscle which can be addressed with a tummy tuck. An examination is needed to see if excess fat is present. Please discuss your concerns with your surgeon.

Until you successfully lose weight, you’re not going to get the results you were hoping for.
You have excess visceral fat, and this cannot be removed surgically.
Obesity is the primary problem not fat distribution.
Try dropping 15 to 20 pounds and take new pictures and watch the improvements happen before your eyes.
Continue losing weight and taking follow up pictures to see further improvements.
Best,
Mats Hagstrom, MD