Hello LEIGHEFF88, Thank you for your question about addressing sagging skin following a tummy tuck (TT). Based on your provided history and photos, it’s understandable to have concerns about the appearance of your skin in different positions. It's normal to experience some degree of excess skin when sitting down after a tummy tuck. This is because a certain amount of skin flexibility is necessary to allow for the full range of motion, such as standing up and sitting down. Removing all the skin to the extent that there’s no excess when seated could restrict movement, which is, of course, not desirable. From your description, it sounds like your tummy tuck results are already quite good. If you have concerns about excess fat in areas like the flanks or love handle region, liposuction might be an option to further contour these areas. However, as you mentioned, if your liposuction was recent, it's likely that some degree of skin contraction is still ongoing. In terms of diet and exercise, adopting a healthy lifestyle with a balanced diet and regular physical activity can help in maintaining and potentially improving your results. Specific diets like a ketogenic diet, as you mentioned, may work for some people, but it's important to choose a plan that is sustainable and fits your personal health needs. For additional skin tightening, non-invasive procedures like Morpheus8 or Renuvion could be considered. Morpheus8 uses microneedling combined with radiofrequency to promote skin tightening and rejuvenation. Renuvion, on the other hand, uses a combination of radiofrequency energy and helium plasma to tighten the skin. It's essential to consult with your plastic surgeon to discuss these options and determine the most appropriate course of action based on your specific needs and goals. They can provide you with personalized advice and help you understand what to realistically expect from any additional treatments. I hope this information is helpful as you consider your options. Wishing you continued satisfaction with your results and the best of luck in your ongoing journey. Sincerely, Dr. Katzen