100 pound weight loss - Tummy tuck or lower body lift? Lipo or no lipo? (Photos)

Congratulations on your weight loss. Losing over 100 pounds is a major accomplishment, and what you’re experiencing with excess skin is very common after that kind of transformation.
For the midsection, based on your photos, most patients in this situation benefit more from a belt lipectomy (also called a 360 tummy tuck) rather than a standard tummy tuck alone. A traditional tummy tuck primarily addresses loose skin and muscle laxity in the front of the abdomen. After massive weight loss, excess skin usually extends around the waist, hips, and lower back. A belt lipectomy would address the abdomen, hips, and buttocks in a single, continuous contour, which leads to a much more balanced result.
I almost always recommend liposuction in combination with skin removal procedures, especially after weight loss. Liposuction is not a substitute for removing loose skin, but it complements it by refining shape and improving overall contour. After weight loss, the skin may be loose, but there is often still residual fat that affects definition. Lipo helps enhance the final balance and contour once the skin is tightened.
When combined with a breast reduction, this surgical plan can restore proportion, improve comfort, and better reflect the hard work you’ve already put into your weight loss. The exact plan should always be customized based on your anatomy, skin quality, and health, but this combination is very common and very effective in post–weight loss patients.

Thank you for your question. Based on your photos, the best choice is a circumferential lower body lift (LBL) instead of a standard tummy tuck because LBL removes and lifts loose skin all around (abdomen, flanks, back, buttocks, outer thighs) and effectively flattens the front while lifting the back. Pair this with a breast reduction with a lift for your chest. Regarding the buttocks, many patients who have lost a lot of weight are poor candidates for BBL due to limited donor fat and lower graft success; if you have enough fat, consider BBL as well. Stage procedures (for example, LBL first, then breasts, then buttock volume as needed) to keep anesthesia time and wound risk low, and improve nutrition (protein, vitamins A/C/D, zinc) before surgery. You’ll need an in-person exam with a board-certified surgeon to confirm if you’re a candidate, plan staging, and decide on the extent of Lipo 360 and BBL based on your available fat and safety.

Answer from Dr. Sean Hill, Board-Certified Plastic Surgeon – Lone Star Plastic Surgery, Frisco, TX:
First off — congratulations on your impressive weight loss. That kind of transformation takes real dedication and is something to be proud of. When it comes to post-weight loss contouring, choosing between a tummy tuck (abdominoplasty) and a lower body lift depends on the pattern and degree of skin laxity around your torso, hips, and thighs — and I appreciate you including photos to guide this assessment.
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Congratulations on losing so much weight! You may benefit more from a circumferential tummy tuck as this would target both the front and sides. Liposuction may be performed at the same time to contour your sides.

Congratulations on your weight loss and thank you for your photos. Clearly, your best result will be from a breast reduction, which includes a breast lift at the same time, to rejuvenate your breasts. You have a circumferential excess of skin and the best way to manage that would be with a lower body lift. There may be some spot areas which could benefit from liposuction, however, a reduction and LBL surgery will likely be about 6 hours and increased time under anesthesia has a progressively higher complication rate. Safety first! Liposuction can always be done after you have healed up from your lower body lift. Best wishes.

First, congratulations on your incredible weight loss, that’s a major achievement and something to be proud of. When it comes to reshaping the body after such a transformation, the best approach depends on where the excess skin and remaining fat are distributed.
If your skin laxity and sagging are mostly in the front of the abdomen, a tummy tuck (abdominoplasty) can tighten the abdominal wall and remove excess skin beautifully. However, if you have loose tissue extending around the flanks, lower back, and buttock area, a lower body lift (LBL) is often the more comprehensive choice. It addresses the 360° contour, lifting the outer thighs and buttocks while smoothing the entire waistline for a more balanced silhouette.
As for liposuction, that’s decided case by case. In massive weight loss patients, the priority is usually skin excision and tightening, since liposuction can sometimes worsen skin looseness if done too aggressively. That said, strategic liposuction, whether to the front or full 360°, can enhance contouring if your skin quality allows it.
In our practice, we often combine a breast lift/reduction with a lower body lift as part of a staged transformation, ensuring both safety and beautiful, natural results. A personalized surgical plan, tailored to your tissue elasticity, goals, and healing capacity, is key to achieving the smooth, defined shape you’ve worked so hard for.
Dr. Sibel Atalay, MDBoard-Certified Plastic Surgeon & Destination Doctor

Thanks for your question and congratulations on the weight loss! Based on your photos, I believe you are a great candidate for liposuction of your abdomen as well as full waistline with a tummy tuck. That would be a great place to start, and if you needed a lower body lift that is something that can be done as well. My office specializes in weight loss patient and we would love to help you! Feel free to schedule a consultation

Thank you for posting your question here ! also congratulations on your massive weight loss , what an achievement!
My answer should not be considered as medical advice since I am not privy to your medical information nor have I examined you.
I would say that for your middle section and for the optimal results I would consider at least lipo 360 with an extended abdominoplasty/ tummy tuck , it is hard to tell how much laxity you have in your buttocks vs cellulite , but if you have a lot of laxity there then you might want to consider adding a lower body lift , but if it is just cellulite then an extended abdominoplasty can take case of the love handles that you see in the back and give you more of an hourglass appearance, I would definitely add liposuction as adding it will help get you a better shape and makes your end result less boxy and more hour glass and when done right and with good judgement it can be coupled with the abdominoplasty surgery safely.I hope this helps, best of luck ! and congratulations again on your life changing weight loss!

Hi there! Thank you so much for your question and for sharing this here.
First of all, congratulations on your incredible weight loss — that’s such a huge accomplishment! I completely agree that a breast reduction and lift will help restore proportion and comfort.
When it comes to the midsection, based on your photos and what you describe, the key isn’t just the name of the procedure but how comprehensively the areas are addressed. Many surgeons use slightly different terminology — “tummy tuck,” “extended tummy tuck,” “360 abdominoplasty,” or “lower body lift” — but what truly matters is that the front, sides, and back of the torso are contoured for a balanced, natural result.
After major weight loss, patients often have skin laxity and diastasis recti in the abdomen, as well as excess tissue around the flanks and lower back. In your case, a circumferential or 360 approach (whether you call it a lower body lift or extended abdominoplasty) would likely provide the most harmonious contour. Liposuction is typically used in combination — not just to the front, but often as Lipo 360 — to smooth transitions and refine the overall shape.
Every patient is unique — anatomy, history, physical exam, tissue quality, goals, skin elasticity, and surgical risk profile all change what is indicated/recommended. Because of this, this should not be taken as personal medical advice. The next step is always an in-person evaluation with a board-certified plastic surgeon that can examine you and discuss individualized plan options.
Hope this helps!
— Georgina Nichols, MD, FACS

Congratulations on your impressive weight loss! From the photos it appears you'd have nice results from an extended tummy tuck with liposuction for contouring. This would address excess subcutaneous fat and skin as well as correct abdominal wall laxity. The best place to begin is a consultation with a board certified plastic surgeon near you. I've included a video that I hope you find helpful.