Hi, Thanks for your question and pictures. Based on the pictures provided, it seems you lost collagen due to the aging process, sun exposure, life style (smoking, excessive loose weight, alcohol, sugar etc.) , genetic etc. This leads to skin losing its elasticity, reduce thickness (skin became thinner) and increase wrinkles and sagging. Our body begins to lose collagen at around 30 years old however the effects become noticeable after several years. Unfortunately, there's no way to stop this process however there are several cosmetic treatments can reduce and build/improve collagen. Over the years, many new devices have become available for addressing skin laxity including laser therapy (e.g. CO2 , Erbium etc.) , radiofrequency (RF) and micro-needling, ultrasound, intense pulsed light (IPL), collagen-stimulating dermal fillers. In you case, it is important to perform a detailed medical ( including age, lifestyle etc.) where the doctor/surgeon is able to give you several options (surgical and non surgical). The key here is to understand what you would like to achieve, what are your expectations. Before to consider any surgical option I would recommend first to start with non surgical/ less invasive option however the results are never guarantee because each patient is different and the results varies patient to patient. In our clinic we offer a bespoke assessment and treatment plan with combination of Morpheus 8 ( 3 sessions 4 to 6 weeks apart)/Bodytite/Accutite/ Renuvion with other aesthetic medical treatments including Profhilo, collagen-stimulating dermal fillers ( e.g. Radiesse, Sculptra etc. ) These combined procedures will allow to increase the probability of skin tightening and so reduce more the risk of "saggy" skin. Aftercare recommendations including healthy diet and exercise can also help. However, if your saggy/excess skin will not improve and so if you are unhappy after at least 6 months then you should consider more invasive options such as surgical treatment to remove the excess of loose skin. I would recommend to make an appointment with an expert body contouring doctor for a medical assessment in order to make a bespoke treatment plan. Hope this helps, Best Wishes, Dr Giuseppe Fiore