What can I do to enhance the appearance of my rib and underarm areas? (photos)

The only way to give you good results is to completely redo that tummy tuck. Way too much skin was left behind by your previous surgeon, you might even need to be converted to a fleur de lis tummy tuck (hard to tell from the photo). In addition your scar could use some improvements as well.

I completely understand your concerns—after a breast reduction and abdominoplasty, it’s common to notice changes in the rib and underarm areas that weren’t as visible before. Fat grafting can help create a smoother transition if there's hollowness or unevenness. If small pockets of fat are causing irregularities, a bit of liposuction can refine the shape. Treatments like Renuvion or BodyTite for skin laxity can improve tightness without additional surgery. Scar revision may also help if tightness or folds are an issue. Strengthening the obliques and upper body can subtly enhance definition and posture as well. You’re not alone in this—refinements after surgery are very common, and there are great options to help you feel more confident in your results.

Hello
You seem to have both horizontal and vertical excess skin. You could have achieved better results with an FDL-type tummy tuck. Currently, I would first recommend Vaserlipo for your back and underarm areas. Afterwards, depending on the existing skin excess, a Back Lift can be done. For the excess fat and skin in your upper abdomen, a revision tummy tuck in the form of Lipoabdominoplasty can be performed.