Thank you for your question regarding what type of tummy tuck would be best for you. Analyzing your pictures, you have excess skin and fat of the central abdomen, lateral abdomen, and lateral upper back. In my opinion, I think you would be best served with an extended horizontal tummy tuck and a bra-line back lift or bra-strap lift, or horizontal torsoplasty. These can be done at the same time. In my opinion, you do not need the vertical component of the tummy tuck AKA fluer de lis tummy tuck. I am very confident that with a good, solid horizontal abdominoplasty which is extended out over the hips, your abdomen will be smooth and flat. By pulling the abdomen down, you will not have too much vertical laxity requiring the vertical incision component of the tummy tuck. In regards to your lateral back fat, the best way to treat this is with an incision that goes across the back. People call this a bra lift or a bra-strap plasty or a horizontal torsoplasty. During this procedure, an incision is made across the back and a butterfly-shaped area of skin and fat is removed. Your extended tummy tuck should take approximately 4 hours. Your back lift should take approximately 4 hours. Again, these procedures can be combined at one surgical setting. These procedures will be done under general anesthesia. Your recovery will be on your back. Plan for at least a 2-3 week recovery. Drains will be required on the horizontal torsoplasty along with the tummy tuck and drains will stay in for approximately two weeks. Please seek an experienced board-certified plastic surgeon who has performed hundreds of tummy tucks and back lifts. Thank you for your question regarding what type of tummy tuck would be best for you. I specialize in reconstructive plastic surgery after weight loss. If you have any more questions regarding a tummy tuck, lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, torsoplasty, bra-strap plasty, or more, please contact my office. Since the abdominoplasty and torsoplasty are big procedures, 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 tummy tucks or torsoplasty 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, tummy tuck or torsoplasty 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.)