Ultrashape and other non surgical and surgical methods of destroying fat cells do not in themselves tighten the skin. Skin tightening with ultrashape or even liposuction depends on the underlying elasticity of the skin itself, if the skin has been stretched out by pregnancy or prior weight gain, it may not rebound as one would like. That being said, the skin laxity is no worse than loosing the weight naturally. There are some additional modalities such as radiofrequency treatments that can be combined with ultrashape or liposuction to add an additional degree of skin tightening after the procedures, I find a series of radiofrequency treatments with a device such as venus freeze or trusculpt, to be more effective than a single treatment with laser lipo, which just focus underneath the skin. In order to get skin tightening you need to generate new collagen and elastin, with thin skin such as the abdomen, this can require multiple treatments. However, if you truly want a significant degree of skin tightening, a surgical procedure such as a tummy tuck is required. In my practice I use ultrashape and coolsculpting on many patients with a degree a skin laxity and they are generally happy as long as their expectations are discussed and realistic. The first decision you really need to make is to decide if you would be willing to undergo a surgical procedure or not. I recommend consulting with a board certified plastic surgeon who performs non-invasive procedures as well in order to learn what procedure would meet your expectations. We offer free consults at our Tysons Corner and Richmond Virginia offices.