Hello, and thank you for your question regarding whether you would benefit more from further weight loss or a tummy tuck. Given your age and history of previous liposuction, it’s likely that most of the fat from your abdomen has already been permanently removed. Because of this, further weight loss likely won’t result in much additional change to the appearance of your abdomen. In cases like yours, most experienced, board-certified plastic surgeons would agree that a tummy tuck—or abdominoplasty—would be more effective than trying to lose more weight. During a tummy tuck, the abdominal muscles (specifically, the rectus abdominis) are tightened to help flatten and firm the abdominal wall. Next, the excess abdominal skin and fat are removed, and finally, a new belly button is created. Since you've already had liposuction and the fat has been permanently eliminated, there’s little remaining fat to target with further liposuction or weight loss. However, what you do have is loose, excess skin—and that’s exactly what an abdominoplasty is designed to correct. For that reason, a tummy tuck would provide you with the most significant aesthetic improvement at this point. If you have additional questions about procedures like the panniculectomy, extended lower body lift, 360 circumferential lower body lift, belt lipectomy, or belt abdominoplasty, please reach out to an experienced plastic surgeon. These are major procedures, and it’s essential to choose a surgeon who is board-certified and has extensive experience in body contouring after massive weight loss. Make sure they’ve performed at least 100 of your desired procedures and can show you before-and-after photos of their work. Be sure to read patient reviews on platforms like RealSelf, and if you’re unable to find a qualified specialist in your area, consider traveling to get the results you deserve. Sincerely, Dr. Katzen (Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)