Would I benefit from a reverse tummy tuck and are there any non surgical alternatives to this procedure? (photos)

Hello and thank you for your question. From the pictures you have provided, you have some striae (stretchmarks) present throughout your lower abdomen, and a minimal amount of excess subcutaneous fat with a moderate amount of excess skin present in your lower abdomen and periumbilical region (around the belly button). There is minimal flank adiposity (excess skin/fat), and no significant upper abdomen adiposity. Based on all this, you would benefit from a traditional abdominoplasty (tummy tuck) to help improve your abdominal/trunk contour. Unfortunately, because your issue is predominantly skin excess to the lower/mid abdomen, there is no less invasive option which would adequately address this. Regarding the transverse lower abdominal scar, it should be well hidden within your bikini or underwear, and if you adhere to proper scar care and sun avoidance after surgery, it should eventually heal to be minimally noticeable.
Regarding a reverse abdominoplasty (reverse tummy tuck)- this procedure places the incision across your upper abdomen along both inframammary folds and connecting the two. It is beneficial for patients who have little to no lower abdomen and periumbilical adiposity, and whose main issue is focal excess skin and especially subcutaneous fat in the upper abdomen, just below their ribs. It is great if combined with a breast procedure, as in your case, as this can help minimize the scars. But unfortunately, your abdominal concerns are located too low for this to even be a reasonable option for you.
As stated above, I would NOT recommend thermage or any less invasive options to address your periumbilical skin excess, as these would only provide significantly suboptimal results, at best.
Liposuction is a great adjunct which could provide some additional benefit, particularly to the contour of your flanks, and can be done at the same time as your tummy tuck procedure for the best possible single operation results.
With all that said, it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from any photos and descriptions provided. I recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

It is possible to do an umbilicoplasty which will remove some of the excess skin around the umbilicus but not all that you have. One option is the upside down tummy tuck using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. This technique pulls up the upper abdominal skin.

Best Wishes,

Gary Horndeski, M.D.

From your photos you are a candidate for a standard tummy tuck which will address loose skin, excess fat, and abdominal wall laxity. You are not a good candidate for a reverse tummy tuck or thermage based on your skin laxity. I've included a video on tummy tuck approaches that I hope you find helpful.