There are four variables to determine what the afternoon looks like. 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. The four different tissue variables that determine what the abdomen looks like are abdominal skin laxity typically due to previous pregnancies or weight loss, excess subcutaneous fat, muscle separation from previous pregnancies, and excess visceral or intra abdominal fat. In your case, it appears you have mild skin, laxity, thin layers of subcutaneous, fat, significant muscle, separation, and possibly mild to moderate visceral fat access. Liposuction only reduces subcutaneous fat. That distribution is not created by previous pregnancies. Previous pregnancies cost muscle, separation and skin laxity. Both of those conditions are best treated with a full tummy tuck. The fact that Liposuction did not deliver quality results the first time I should tell you that subcutaneous fat is not the issue at hand. Sufficiently talented the plastic surgeon should be able to make an accurate assessment and deliver predictable outcomes. I suggest having multiple interpersonal consultations with local board-certified plastic surgeons in your area. A qualified surgeon should be able to give you a quality assessment and explain different surgical options of which most likely a tummy tuck is going to be the best choice. During each consultation, ask each provider to open up their portfolio and show you the entire collection of before and after pictures of previous patients with similar body characteristics to your own. And experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. continue scheduling consultations until you feel quite confident you found the best provider to meet your needs. Secondary Liposuction typically offers very little in comparison, to what can be obtained from the first procedure. Best, Mats Hagstrom, MD