Post lipo 360 and loose skin. Is skin excision the only real option for me? Photo)

Hi and welcome to our forum!
From your photos, I note a significant decrease in the amount of superficial fatty tissue following your liposuction. There is, however, a degree of skin laxity noted at the flanks and a roll of skin laxity or residual fatty tissue appears to be present at your suprapubic area.
Fullness may be due to superficial fatty accumulation and may stretch the overlying skin to a point where the skin's dermal elastic fibers rupture, resulting in the loss of elasticity. The skin will stretch over a greater surface area. After the fatty deposit is removed, the lax skin may fall into folds.
An upper back lift will remove the lax skin, eliminating the folds of skin at the expense of a transverse scar within the bra line.
If the suprapubic fullness is due to underlying fat, a secondary liposuction may be indicated. If due to loose skin, a mini-tummy tuck would eliminate it. Without an examination, I cannot differentiate.
Non-surgical skin tightening alternatives include Emsculpt , Exilis, and thermage.
Revisit your plastic surgeon for evaluation and discussion.
Best wishes...