How Do I Know if I Need a Tummy Tuck or Lipo?

Without seeing you or examining a patient it is impossible to say what they would be best served having, either liposuction or an abdominoplasty. For those patients whose skin has fallen loose, a skin and subcutaneous tissue tummy tuck may be all they need. For those whose connective tissue envelope, fascia, has weakened by large weight gain or pregnancy, the fascia may not be able to prevent the muscle wall of the belly from bowing forward which creaetes a big bulge. When the doctor examines a patient, they feel the fat compartment under the skin and above the muscle. They might have you tense your belly muscle, when you are lying down by lifting your heels off the table and seeing how much fat is above the muscle. While standing and bending forward as if you were diving into the water, the profile of the abdomen is examined for a weakening of the muscle wall. If there is little fat but a big bowing forward, then a tummy tuck with muscle tightening is in order. See a board-certified plastic surgeon or dermatologic surgeon who performs a lot of liposuction. There are some patients who benefit from both procedures, liposuction and a tummy tuck, but they may be done at different times for safety issues (there could be a fat embolus traveling to the lungs, which could be fatal, when both procedures are done together. I have performed liposuction on the abdomen and after healing referred my patient to a plastic surgeon for a tummy tuck with very good results.

Hi there-
This is actually pretty straightforward...
Liposuction involves the removal of fat from between the muscle layer and the skin, and to achieve a good outcome requires skin with good elasticity or tone, so that it will contract after surgery and look smooth. Liposuction will not improve the appearance of skin that has lost its elasticity, or muscles that have become loosened by pregnancy.
For women that have experienced a loss of muscle tone and or have true skin excess, a tummy tuck is a much better option.
But the only way to know the option that is best for you is to visit with a Board Certified Plastic Surgeon for a consultation.
Need help finding one? Please read this:

The true way is to see a board certified plastic surgeon to exam you. 
Some things that point you more towards a tummy tuck is multiple pregnancies, loose skin, skin with stretch marks and bulging of the abdomen when you are completely relaxed.
Hope that helps.