Thank you for your question, Shawna714. After having four kids, including a set of twins, it's understandable to be concerned about excess skin and the prospect of a tummy tuck. While a tummy tuck is a common solution for excess skin, there are some non-surgical options you can consider. Treatments like radiofrequency skin tightening, ultrasound therapy, and laser skin resurfacing can help improve skin elasticity and reduce the appearance of excess skin. These treatments, however, may not be as effective as a tummy tuck for significant excess skin. Consulting with a board-certified plastic surgeon can provide you with a better understanding of what to expect and help you choose the best option for your needs. Good luck! Sincerely, J. Timothy Katzen, MD, FASMBS, FICS