Thank you for your question regarding whether you need a body lift or an extended tummy tuck. Based on your history of two kids and 50-pound weight loss, I would highly suggest a 360 circumferential lower body lift. Based on your pictures, especially the second picture, where you show a picture of the buttocks, you have excess skin and fat above the buttock crease. Based on your weight loss history and your pictures, I would highly suggest a 360 circumferential lower body lift. This would permanently remove excess skin and fat from the lower abdomen, upper abdomen, mons region, lateral hips and upper buttock region. This will permanently remove back, flank and saddle-bag fat far better than liposuction. In addition, you will get a much better shape than with just liposuction. Therefore, my opinion is to go with the lower body lift, rather than the extended tummy tuck. I hope that I have answered your questions whether you should have a 360 circumferential lower body lift or extended tummy tuck. I specialize in reconstructive plastic surgery after weight loss. If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the lower body lift. Do your research. Make sure they have performed at least 100 circumferential lower body lift surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced, lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)