Hi Thoughtful500330, Thank you for your question regarding what to do with your abdomen and would you benefit from lipo with Jplasma and abdominal etching. Thank you also for including your pictures. First, let’s analyze your pictures to determine your optimal surgery. Basically, when a plastic surgeon analyzes the abdomen, there can be three areas of anatomic concern: muscle weakness, excess fat, and excess skin. In regards to skin, you don’t have much skin laxity. In regards to fat, you have a mild to moderate amount of fat, but not extreme. In regards to muscle, you have significant muscle weakness What strikes me as your biggest issue is muscle weakness. Your muscle weakness is more important than excess fat or skin laxity. This can be seen on the profile pictures of your abdominal wall. Your muscle weakness can be seen in the second and third picture you provided. Since muscle weakness is the main issue, I would suggest muscle tightening. Muscle tightening can be achieved through an incision low in the pubic region. Tissue dissection is done to the sternum, the rectus abdominis muscle is exposed and tightened. In my opinion this would give you the best and flattest abdomen. If you do not tighten the rectus muscle and just had Jplasma or abdominal edging, you will have muscle definition, but the abdominal wall will still be distended due to the muscle weakness. In my opinion, you must fix the muscle weakness first. If you have any more questions regarding the tummy tuck or abdominoplasty, please contact my office. Since an abdominoplasty can be a difficult procedure, please seek an experienced, board certified plastic surgeon with significant experience performing tummy tucks. Do your research. Make sure your chosen plastic surgeon has performed at least 100 abdominoplasties. Make sure they have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. Good luck! 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, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)