What do I need? A panni, tummy tuck, full tummy tuck or a fleur de lis? (photo)

For aesthetic improvement, I would recommend a full tummy tuck to address your abdominal wall laxity as well as contour your flanks, and upper abdomen.  Losing the 20 pounds and exercising prior to the tummy tuck would be prudent to achieve the best results possible.  After healing, you could consider a panniculectomy for hygienic reasons to prevent rashes/ excoriations, and infections.  Best to consult with a board certified plastic surgeon to determine the path best for you at age 26.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

From your pics looks like you have multiple options. It’s possible a boas of tummy tuck could work but you’ll need a few consults in person to determine skin laxity and see. Choose a surgeon with experience in weight loss. Good luck!!

At minimum, you would require a full tummy tuck, possibly with fleur-de-lis or a lower body lift depending on posterior lower body skin laxity. This is impossible to ascertain from a photo. You should schedule some in person consultations to discuss your options. It is unlikely your insurance will cover the procedure based on your photos. Best of luck.

Hello and thank you for your
question. Congratulations on your weight loss.  Based on your photographs, you are a great candidate for a tummy tuck
with liposuction.  This can be done
through a low and short incision, all completely below the bikini line.  The belly button can be designed to look
natural and have no scars on the exterior.  
Your muscles can also be plicated resulting in a flat abdomen.  Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.  The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

from your photos it appears you have excess skin of the hips and upper buttock region. A circumferential abdominoplasty would give you a nice result. Make sure you see a board certified Plastic surgeon.

Hello!Your best bet cosmetically would be a full tummy tuck with muscle repair. You need a board certified plastic surgeon who does this type of work - check out photo galleries for examples of each surgeon's work. This surgery is not covered under insurance. Insurance sometimes covers panniculectomy, which is removal of lower abdominal skin alone, but this is a 1 hour procedure aiming for reduction of rashes. Typically panniculectomies are only covered if the skin overlaps the pubic area onto the thigh. Your best long term solution is a tummy tuck with muscle repair.