Liposuction only removes subcutaneous fat. It doesn’t matter what the name is associated with Liposuction or what equipment is used for procedure is a fat producing procedure. Liposuction, regardless, secondary treatment is done with it whether it be laser, radio, frequency, or heat will not create significant skin tightening, and certainly nothing in comparison to what a tummy tuck can accomplish. There are four variables that determine what someone’s abdomen looks like. The choice of procedure should be based on having a clear understanding about the underlying problem is. In other words, if somebody doesn’t like the way, their belly looks it is always because of one or more of four different tissue variables. Each of these tissue variables has its own way of being treated so understanding which tissue variable is causing the problem, helps dictate what the best treatment is. The four variables that determine what someone’s abdomen, looks like our abdominal skin laxity typically due to previous pregnancies or weight loss, excess, subcutaneous, fat, muscle separation from previous pregnancies, for excess visceral or intra-abdominal fat. Pregnancies cost to advertise changes. Pregnancies can cause skin, laxity and muscle separation. Women who have pregnancy related changes need to have procedures that address those two tissue variables. A tummy tuck specifically treats abdominal skin laxity, and muscle separation. To assess how much skin laxity is contributing tried pulling your skin tight and see if it improves your abdominal contour. To assess the thickness of your subcutaneous fat layer, you can take your finger tip and gently press your skin until you feel the underlying muscle wall. this does not require much pressure at all. I’m guessing your subcutaneous fat layer. It’s about an inch thick. A tight flat abdominal wall should create a B line between your sternum and your pubic bone. Based on your pictures you abdominal wall is bulging. Both muscle separation and excess visceral fat can cause muscle bulging. If your abdominal wall was always tight and flat pre-pregnancy, and you’ve not gained significant weight since your first pregnancy, then the bulging of your domino wall is most likely mostly related to muscle separation. It is important to differentiate and make sure you don’t also have visceral fat because individuals who have access visceral fat, will have limited results from a tummy tuck, unless the address to access visceral fat first. One easy way to differentiate if abdominal bulging is due to muscle, separation or excess visceral fat is to see if your abdomen goes completely flat when you lay on your back. If it does, then the problem is most likely all related to muscle separation. If you still bulge while laying on your back, then visceral fat is probably contributing and should be addressed through weight loss. Liposuction can remove 50 to 75% of your subcutaneous fat layer. This means it’ll bring in your abdomen by 1/2 to 3/4 of an inch. That is not enough to gift you a flat abdomen. It is however going to give you some improvements and the parts of your body with Liposuction it will work better I’m going to be in your waist, love handles back. Most likely it is your abdomen that is bothering you the most and that is most likely all related to previous pregnancies. Again, pregnancy related changes come down to muscle, separation and skin laxity both which are best treated with a full tummy tuck. Lots of people don’t want to have a full tummy tuck and I don’t blame them. There’s nothing wrong with choosing Liposuction but don’t expect Liposuction to get you a tight flat abdomen. If you want a tight flat abdomen, you will need to have a full tummy tuck. Additionally, if you have excess visceral, fat weight loss needs to be included or you will still have some bulging after. To get a more accurate assessment and better understanding of treatment options I recommend you have multiple in person consultations with local board-certified plastic surgeons. Don’t be sold on technology or names of fancy equipment. There is very little difference between different modalities of Liposuction. The only variable that matters when it comes to quality results is who does the procedure. Plastic surgeons have the tools they need to do their job right. Whether outcomes come out as quality outcomes or not is more related to the skill of the surgeon. In the end, there are only two variables, that really matter when it comes to quality plastic surgery outcomes. The first one is patient candidacy, and the second is the skill of the surgeon. Focus all your efforts on these two variables. Don’t spend time trying to figure out what form of Liposuction works better. You will only get confused by people who are self promoting, purposely creating confusion in the marketplace. In regards to candidacy, you are an OK candidate for Liposuction, and an excellent candidate for a tummy tuck. In other words, Liposuction will give you a modest improvement while a tummy tuck will give you an excellent outcome. You’re a much better candidate for a tummy tuck than you are for Liposuction. The reason for this is subcutaneous fat, is not the primary variable, causing your abdomen to look the way it does. The problem is related to muscle, separation and some degree to skim laxity. Subcutaneous fat is contributing to some degree and like I mentioned, earlier, visceral fat may or may not be a contributing variable as well. I suggest you start by having five in person, consultations with local board-certified plastic surgeons. During each consultation, ask each provider to open up their portfolio and show you their entire collection before and after pictures of the previous patients who have similar body characteristics to your own. You can do this for both Liposuction, and tummy tucks. Bring pictures of your own body to use in comparison. When looking at before, and after pictures, make sure you recognize patients in the before pictures as also having bulging abdominal walls with similar amounts of subcutaneous, fat, and similar amounts of skin laxity. There’s no point in seeing results from patients who had different kinds of disease or had a different body types compared to yours. Being shown a handful of preselected images, representing the best results of a providers career is insufficient to get a clear understanding of an average results look like or how many of each procedure anyone surgeon has actually done. You should ask providers to show you examples of excellent outcomes, average outcomes, and outcomes that did not turn out as they had hoped. Providers may be apprehensive to show you anything but their best results. You need to be a little insistent make sure that they show you enough before and after pictures. For reference an experienced surgeon that should have no difficulty showing you at least 50 sets of before and after pictures of common procedures, like abdominal liposuction for a full tummy tuck. Delivering consistent quality liposuction results is more difficult than most people believe. Of the two procedures, there’s more variation in outcome based on the provider you choose when it comes to Liposuction. Anybody, considering Liposuction it should be far more selective than they ever thought necessary.Bing board-certified in plastic surgery with years of experience and overall good reputation does not mean that somebody has mastered Liposuction. Doing Liposuction well on a consistent basis including the ability to make accurate assessment and Deliver predictabl results is far more difficult than most people believe. The number of plastic surgeons are truly excellent at Liposuction is relatively small. There is, of course, variation in outcomes with tummy tuck results as well. When judging tummy tuck results look very carefully, and who gets the most natural looking belly buttons, with a very low sets car that follows an atomic contours, naturally unevenly on both sides. Decision you make now will have an impact every day for the rest of your life. Now is the time to be selective and spend sufficient time and effort. I’m fighting the best providers and choosing the correct procedure. Do not rush through this stage of the process. Take your time and have lots of consultations. When, in doubt, simply slow down and schedule another consultation. Most plastic surgeons will probably tell you you need a full tummy tuck. There’s nothing wrong with choosing Liposuction, but don’t expect Liposuction to give you a result comparable to what a tummy tuck can. Best, Mats Hagstrom, MD