What is the best option for my stomach: Thermage, Tummy Tuck or Fraxel?

Tempting to try thermage or fraxel,  but they won't do anything for your abdomen.  A tummy tuck will give you a flat abdomen but as you know, it  is an operation requiring a pretty long scar.

It is great that you are in such good shape after 2 pregnancies. While I completely understand the desire to avoid surgery, the alternate procedures you mentioned will not remove stretch marks and tend to be quite costly. I can't be sure without examining you, but from your photo, it is possible that you have separation of your abdominal wall muscles called rectus diastasis. This muscle separation is fixed only with tummy tuck surgery, and would be another reason that tummy tuck may be your best option. See a surgeon certified by the American Board of Plastic Surgery and learn about your options.

Forget about Thermage and Fraxel.  Modified fitness type procedure best if you want to see and feel a difference, provided pregnancy is not in your future.

Hi, Lululi.  Yours is a very common scenario and request that I see.  After two pregnancies, there is stretching of your abdominal wall which results in lower tummy bulging, loose skin, and stretch marks.  Even in thin and fit women, there is no great non-invasive techniques to treat these problems.  I don't think Thermage will give you any appreciable long term results that truly fix these problems.  A tummy tuck will solve a couple of these problems by flattening your tummy, tightening the skin, and removing the stretch marks below your belly button.  Some of the stretch marks above your belly button will not be removed, but will be shifted down towards your bikini line.  The downsides of tummy tuck are the scar -- but will be below your bikini line so you'll still be able to wear a two piece and conceal the scar -- and the down time for recovery.  Because you don't have much extra skin, the skin around the belly button would be sutured together as a short vertical line that would be positioned along the midline of your body just above the lower incision.  An in person consultation is the best way to show you what you can reasonably expect, and if interested, I can put you in touch with several of my patients that presented with similar body types and underwent tummy tuck surgery.

   There may not be a great option aside from tummy tuck.  You may not be a candidate for tummy tuck.  I would go for consultation and get examined to determine what may be best for you.Kenneth Hughes, MDLos Angeles, CA