Hello, thank you for question and pictures. Based on the picture you provided. Based on these pictures , I would suggest first to loose weight but very slowly (e.g. 2 pounds per months) in order to reduce the risk of very saggy skin. However the first option should be abdominoplasty (tummy tuck) and Vaser Lipo on the flanks and Back area. This surgical option involves skin removal and can provide better results for excess skin on the abodminal area. If you prefer a less invasive procedure and avoid the bigger scar, then the second option could be Vaser liposuction combined with Renuvion/J plasma or Bodytite on the upper and lower abdomen, flanks (anterior and posterior), and back area (360-degree approach). This method is ideal for fat removal and body contouring and can also improve the waistline if your body allows for it. The combination of Vaser liposuction with J plasma-Renuvion or Bodytite can help increase the probability of skin tightening. The second option is for patients who refuse the abdominoplasty and want to reduce the fat on the abdominal area and improve the body shape and waist line. In my clinical practice, I prefer using Renuvion and usually combine it with Vaser liposuction as I believe it provides better results in terms of body shape and skin tightening. Renuvion only requires one session and is typically performed under general anesthesia or sedation in a hospital setting. Bodytite requires as well 1 session in combination with Morpheus 8 ( 3 sessions 4 weeks apart). My approach , which involves circumferential body Vaser liposuction and Renuvion/J plasma, is an excellent option for women or men who want to improve their body contour and silhouette with fewer scars and avoid a tummy tuck. Before undergoing Vaser liposuction, a preoperative assessment is necessary to determine if you are a suitable candidate. This may include factors such as a BMI less than 30-32, overall health, and any medications you are taking. I strongly recommend scheduling a consultation with one expert body contouring surgeon for a medical and surgical assessment to determine the best treatment for you. I wish you all the best in achieving your desired results. Dr Fiore