Thank you for your question! You need a formal evaluation by an expert in body shaping and contouring to determine what is best. You will likely need to lose weight first before undergoing any cosmetic procedure to get the best outcome. For best results, it is recommended to be at your ideal or stable weight before getting a sculpting liposuction procedure. Liposuction is not a weight loss procedure; rather, it is for sculpting, defining and removing problem areas that cannot be removed with weight loss, diet and exercise alone. If skin is very loose before surgery, then it will need to be removed: tummy tuck/abdominoplasty for lower abdominal skin; breast lift for excess breast skin; and/or a brachioplasty for loose arm skin. In the meantime, I recommend getting a formal evaluation with a bariatric doctor or dietitian. Best, Dr. Emer