The decision of what treatment you choose should be based on the underlying primary and secondary problems i.e. diagnoses.there are four variables that can change what someone’s abdomen looks like and each one of those variables is treated differently. The four variables are skin laxity, excess subcutaneous fat, muscle separation from previous pregnancies or excess visceral or intra-abdominal fat. A tummy tuck primarily treats pregnancy related changes which are skin laxity and muscle separation. Pregnancies do not change fat distribution. To assess the impact of skin laxity pull your skin tight and look at the contour difference. That is what skin laxity is contributing. to assess the thickness of subcutaneous fat take one finger and gently touch your skin and push in with the skin slightly tight until you feel the underlying muscle wall. It’s a very gentle push and in your case the thickness of your subcutaneous fat around your belly button it’s probably about 1 inch. you can expect half of 3/4 of that to go away with Liposuction. It will however not tighten your skin and despite all the claims neither will alternatives to a tummy tuck. this includes bodytite and JPlasma a.k.a. Renuvion. I owned the Renuvion device when it first came out for cosmetic purposes and used it for about a year. Not a single one of my patients nor did I notice any skin tightening on any of the patients we treated. renuvion cost significant increased pain during and after the procedure. That was the only difference I could tell from using the device. I have since sold it at a substantial financial loss and wish I never bought it. Save your money and skip the Renuvion. If you want to tight flat abdomen then you need a full-time he talk. Maybe now is not the right time or maybe you don’t want or need that but that’s the correct procedure for skin laxicity. anything less than that will most likely leave you disappointing. If you simply want the fat layer to be thinner around your midsection then you can expect your skin to come in by about 3/4 of an inch with well done Liposuction. Delivering consistent quality liposuction results is more difficult than most people believe it. This includes plastic surgeons. The results from both Liposuction and a tummy tuck are permanent and more or less irreversible. For liposuction especially because there’s results very so much depending on who does the procedure provider selection becomes paramount and the most important decision patients make. In some regards the choice of sturgeon may potentially even be more important than what procedure you choose. I would not discount local plastic surgeons and start by interviewing those in your community first. They’re generally talented plastic surgeons in most communities though there may be more to choose from in more populated areas. It’s generally not a good idea to travel long distances for elective surgical procedures. Like I said there are exceptions and if you travel frequently and can do it in person consultations an in person follow up as well as be available should there be issues after surgery then traveling is perhaps reasonable. During in person consultations think about how detail oriented your surgeon is about the procedure you are contemplating. The provider genuinely seem excited and like they like to do this procedure? many plastic surgeons really don’t like to do liposuction and the results typically reflect their lack of enthusiasm. When reviewing before and after pictures ask each provider to open up their portfolio and show their entire collection or at least as many as they are willing to. Simply sing a handful of pre-selected pictures which most likely represent the best results of the providers career is insufficient to get a clear understanding and what average results look like in the hands of each provider. Ask to provide her to show examples of excellent outcomes, average outcomes unless than outcomes. As the provider to select pictures of patients who have similar body characteristics to your own. Look carefully at all areas treated and scrutinize them for any skin contour irregularities, debits, wrinkles or other imperfections. There should be none. Ask the provider to review with you in each picture what areas were treated and what areas were not treated and look carefully at transition zones between treated and untreated areas. An experienced provider should have no difficulty showing you a minimum of 50 or more quality before and after pictures of common procedures like abdominal liposuction. in reality highly experienced surgeons will have hundreds or even thousands. Make sure you have a very clear understanding exactly what areas will be treated and what areas will not be treated. personally I view the torso as a single anatomic unit and prefer to treat the entire torso or not do abdominal liposuction. in other words I generally do not like to spot treat detorso and only treat the problem areas or certain areas that the patients won’t treated. Doing that typically leads patience with abnormal fat distributions that look unnatural an undesirable. instead treating the entire torso as a single unit including all the areas of the torso leaves patients with a natural even thin distribution without evidence of transition zones between treated and entryed areas. A full torso includes upper abdomen, lower abdomen, love handles, waist, full back and under arm area all the way to the side of the breast. Finally I recommend reading all reviews on various physician review websites avoiding providers with any significant number of justified negative reviews. The absence of justified negative reviews is more important and more telling than having an abundance of positive reviews. Continue having consultations until you feel quite certain you found the most talented and experienced provider. once performed the results cannot be corrected and if done poorly patients are left disfigured for life. My practice has been devoted exclusively to Liposuction and fat transfer procedures for well over a decade. I have performed over 8000 liposuction procedures. i’ve been a plastic surgeon for almost 20 years. Halfway through my career I began specializing exclusively in liposuction and fat transfer procedures only and gave up all other cosmetic surgical procedures. This is allowed me to get an exceptional amount of experience doing body contouring with all the major modalities. When I look at my own history when I was doing general plastic surgery I used to think I was pretty good at Liposuction. The truth is my results were probably average width of the plastic surgery but they were poor and especially unpredictable in comparison to where I am today. In the end the choice of procedure often comes down to what the patient is trying to achieve and what you’re willing to go through. Some patients a good candidate for Liposuction and others simply are not. I would say in your case without an examination I’m guessing that you are a fairly good candidate for Liposuction probably a 6-7out of 10. Ideal candidates for liposuction can often be described with the three words “young tight and pudgy.” The opposite is also true. Equipment is fairly irrelevant when it comes to body contouring and plastic surgeons have the tools they need to do their job correctly. Having some particular device does not give it any plastic surgeon any significant up or advantage on they’re colleagues down the street. In plastic surgery like almost every other trade it is the inherent skill and experience determines the ability to deliver consistent quality results on a regular basis. there are of course exceptions and much of this are generalizations and they are certainly my opinion. Other providers will have different opinions and different experiences. Few have the experience that I do. When ended slow down and schedule more consultations. Weight loss almost always makes everybody look better and for some people with sufficient weight loss the need for liposuction starts to disappear. For others losing weight will still leave them with a fat distribution that’s undesirable and some still have other variables like skin laxity that often looks and feels like fat but is in fact loose skin. Good luck with your decision making. Whenever possible I recommend you avoid virtual consultations. In person consultations are simply better for both the surgeon and the patient. Best, Mats Hagstrom MD