Would you recommend lipo 360 or tt with lipo?

Healthy people at their ideal weight should have the best overall recovery from a TT, but some of this will depend upon the surgical technique and adherence to postoperative protocols.
A TT addresses both the loose skin and the lax abdominal wall as to give a nice, flat youthful contour to the abdomen.  The TT also creates a more youthful belly button and removed c-section scar.
TT without muscle repair may make the recovery easier, but, if you have laxity in that area from your four pregnancies, the result will be better with plication. In general, the muscles should be brought to anatomic norms. The smaller the separation, the less tightening required and probably the less discomfort. Swelling will occur irrespective of muscle repair, and almost every patient requiring a TT will benefit from the muscle repair.
Liposuction, along with the TT, will allow you to have stubborn fat resistant to exercise and diet removed from unwanted areas (stomach, flanks, back) and also result in a waist as small as possible.  A smaller waist may make the buttocks more conspicuous, but definition will not change

Hello and thank you for your question. Based on the photo, I
believe you are a better candidate for a tummy tuck, which can be combined with 360 liposuction. During tummy tuck,
extra skin in the lower half of your abdomen including the stretch marks will
be removed. In addition, typically the fascial laxity/separation of recti
muscles will be taken care of by muscle plication, giving you a flat
abdomen. The added liposuction of your hips/flanks will help with creating a
natural and aesthetic waistline. Incision can be placed very low to be
hidden under bikini. With proper surgical technique, belly button can be
designed to  be a true 'innie'. Recovery from tummy tuck is 1-2
weeks. Strenuous activity and lifting heavy weights should be avoided 6 weeks
to 3 months post op. I would seek consultation with a board-certified
plastic surgeon for a full evaluation and advice. Best,
Pejman Aflaki, M.D.                                            
Johns
Hopkins-trained double board-certified plastic surgeon