I am 38, 5'1 feet, and weigh 155 lbs. Lipo or Tummy Tuck? (photo)

You can just have liposuction but that does not meet you should or that you would be happy with the result. You can also do liposuction and then have a tummy tuck at a later date as the first does not preclude the second.

Your posted photos show a very prominent abdomen but it does not hang down over your undergarment when standing and the belly button is fully visible when standing. That means your abdominal muscles have been stretched out by 3 pregnancies and there is some excess fat but not as much excess skin as we normally see. If you want a flat abdomen you will have to undergo a standard tummy tuck with suture tightening of the muscle and some liposuction. If you just want the waist brought down a bit any of the liposuction modalities available alone will suffice. Liposuction of any type will not tighten that loose muscle and if the muscles have been separated by the pregnancies no amount of exercise will achieve that goal either.

I cannot comment about your breast lift in the absence of a photo of the area.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Both liposuction and tummy tuck (abdominoplasty) are for conditions that do not respond to diet and exercise. If skin tone is good then lipo may be an option, but the photos show that the skin has been stretched quite a bit. In that situation a tummy tuck is the way to go. A plastic surgeon who does both tummy tucks and liposuction will be in the best position to give you honest advice about which one is best for you. Be espaecially wary of advice that laser lipo will tighten the skin enough to avoid the tummy tuck - it won't.