You have very good questions and concerns.Skin can retain much of it's elasticity or it can be stretched and have lost the ability to retract. We see this loss of elasticity after considerable weight gain then loss or often after pregnancy, as in your case. The telltale signs of lax skin are stretch marks (stria). Simply put, these stria are tears in the deeper layer of the skin called the dermis. Unfortunately, these do not resolve by themselves. If there are a lot of stretch marks and the skin is loose, then there are few options other than to remove the excess skin. Unfortunately from the photograph you sent, there is little in the way of excess skin so a mini tummy tuck would only remove a small portion of the stretch marks and would extend the scar further. You would be left a bigger, possibly worse scar and essentially the same stretch marks. With respect to the scarring, there are many factors can affect the ultimate quality of the scar. Individuals who demonstrated poor scarring in the past and those with a family history of suboptimal scarring should be considered high risk for developing unsightly scars. Another very significant factor in determining how a wound will scar is how the wound was initially created. Surgical wounds that have been carefully created are likely to heal with less scarring than a traumatic wound with considerable tissue injury and irregular borders. Unfortunately, you seem to have propensity to develop thick (hypertrophic) scars. This is mostly in your genetic makeup and is not going to change. You should think very, very carefully before agreeing to any additional surgery.There are numerous techniques and preparations touted to decrease or limit scarring, but only a few have been scientifically shown to have any real benefit. Moisturizing lotions should be applied frequently to all scars. It is critical to avoid significant sun exposure, as this can lead to hyper-pigmented and prominent scars. The use of tape or steri-strips to relieve tension on the wound has been found to be helpful. There has been some evidence to suggest that silicone sheeting, or liquid preparations containing silicone, can enhance the appearance of scars if used early and often in the healing process. Steroid injections can soften and flatten very thick, hypertrophic scars and keloids. Pressure dressings have long been used in burn victims with good clinical results and remain an important adjunct. Finally, time alone will result in considerable improvement in most scars. I recommend you use a silicone product for the fresh scar and leave the belly button scar alone. I sympathize with your situation. It is a very difficult one but one with few, if any, good options. BRK