40 year old female, 1 child. Gained weight after pregnancy. What are my options without going abroad? (photo)

Dear elijahp90,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question and series of photographs.  Nothing replaces an in-person examination, but I think you would most benefit from a full tummy tuck and liposuction of your waist and flanks.  The tummy tuck will tighten your stomach muscles, helping to achieve a flatter appearance, while removing excess skin and adipose tissue.  Liposuction can be used to enhance your tummy tuck results by narrowing your waist and removing isolated areas of diet and exercise resistant fat.  I would favor the full approach because it appears that your skin and muscle laxity is present above and below your belly button. Hope that this helps