Hello, and thank you for your question regarding whether a tummy tuck or a less invasive procedure would be the best solution for stretch marks and excess skin above your belly button. I appreciate your history and the pictures you provided. Based on your description and photo, you have excess fat in the love handles and central abdomen, along with skin laxity and stretch marks above your belly button. If your primary concern is fat removal and body contouring, you may benefit from liposuction, specifically VASER high-definition liposuction, which sculpts the muscles while removing fat. However, liposuction alone does not address excess skin or stretch marks, and it may actually make loose skin appear worse after fat removal. If you are most concerned about a single stretch mark above your belly button at the 12 o’clock position, a vertical excision of that specific area may be an option. However, if you have stretch marks and loose skin throughout the abdomen, a full tummy tuck (abdominoplasty) would be the only comprehensive solution. A tummy tuck removes excess abdominal skin, tightens the muscles, and repositions the belly button, effectively eliminating most stretch marks located below the new belly button placement. If your stretch marks and excess skin are mild, you could consider less invasive treatments like radiofrequency skin tightening, laser treatments, or microneedling, but these will only provide minor improvements and will not remove the stretch marks completely. If you are looking for a permanent and dramatic improvement, a tummy tuck would provide the best results. I recommend consulting with a board-certified plastic surgeon who specializes in body contouring to discuss your goals and determine the best approach for you. Good luck, and I hope this helps answer your question regarding stretch marks and excess skin above the belly button. Sincerely, Dr. Katzen