Hello, Thank you for your question and for providing your photos. Ideally, a physical examination of your abdomen would be necessary to determine the exact cause of the fullness. In my clinical practice, I conduct a thorough physical examination to differentiate between potential factors such as the accumulation of fat beneath the skin, the presence of internal visceral fat, or a separation of the anterior abdominal muscles due to a previous pregnancy. Each of these factors requires a different treatment approach. When discussing treatment options with my patients, I always present several choices ranging from more invasive to less invasive procedures. One option is abdominoplasty, also known as a tummy tuck, which is suitable for patients seeking a flatter and more toned abdomen. This procedure involves removing excess skin and tightening the underlying muscles to create a contoured and firm abdominal appearance. However, it is important to note that this procedure does result in a significant scar on the lower abdomen. Another less invasive option is Vaser liposuction combined with Renuvion/J plasma or Bodytite, targeting the upper and lower abdomen, flanks, and back area. This approach is ideal for patients looking to contour their body and improve their waistline with fewer and less extensive scars. It's worth mentioning that this procedure does not remove excess skin. Combining Renuvion with Vaser liposuction can enhance the potential for skin tightening. My preferred method involves circumferential body Vaser liposuction (360-degree approach) and Renuvion/J plasma, which is an excellent choice for individuals seeking body contouring and silhouette enhancement while minimizing scarring and avoiding a tummy tuck. Renuvion typically requires only one session and is performed under general anesthesia or sedation in a hospital setting. Bodytite, on the other hand, requires one session in combination with Morpheus 8 (three sessions four weeks apart). It is important to note that liposuction is not a weight loss procedure and does not address visceral fat. Therefore, I strongly advise my patients to maintain a healthy diet and engage in regular exercise to achieve overall wellness. I would recommend scheduling an appointment with a surgeon who specializes in body contouring and skin tightening. They can assess your specific situation and recommend the best course of treatment for you. During your consultation, they will also discuss any potential risks and benefits associated with the chosen procedure. I hope this information helps. Best of luck with your journey. Warm regards, Dr. Giuseppe Fiore