Thank you for sharing your pictures and history regarding your concerns about your abdomen post two C-sections and a bellybutton piercing. After careful examination of your skin condition, I suggest a tummy tuck as the most effective solution to correct the appearance of your bellybutton and abdomen. Your skin exhibits stretch marks and laxity, which unfortunately makes liposuction an unsuitable option. Merely making an incision around the bellybutton won't provide significant skin tightening either. Therefore, a tummy tuck appears to be the most appropriate course of action. During a tummy tuck, an incision is typically made in the pubic region, followed by dissection up towards the bellybutton. This procedure involves tightening the abdominal muscles and removing excess skin from the pubic area to above the bellybutton. Additionally, the bellybutton will be reconstructed to enhance its aesthetic appearance. I hope this provides clarity and guidance regarding your options for improving the condition of your tummy after two C-sections and a bellybutton piercing. Sincerely, Dr. Katzen