This response is dictated so I apologize in advance for grammatical errors. I’m also going to make an assumption that you have children or have had term pregnancies. If I am wrong on that, then please forgive me and ignore anything written below regarding pregnancies. To make a quality assessment regarding the outcome of a plastic surgery procedure, we need to see a complete set of proper before and after pictures. If you don’t have before, and after pictures, then ask your surgeon to forward the ones they took. Without knowing what you look like before the procedure, we can’t really assess the improvement of your operation. Other variables that would be very important to know in order to make a Liposuction assessment is what your current weight is in comparison to your weight before the procedure. The second most important variable for us to know when making an assessment is if you have a history of term pregnancies. There are four tissue variables that determine what the abdomen looks like. These are 1) abdominal Saxity due to previous pregnancies or weight loss. 2) excess subcutaneous fat. 3) muscle separation from previous pregnancy. 4) excess visceral or intra-abdominal fat. It looks to me like you have mild skin, laxity, thin layers of subcutaneous, fat, mild to moderate muscle, separation from previous pregnancies, and most likely a minimal excess visceral fat guided. If Liposuction didn’t get you the results, you wanted the first time then the problem most likely isn’t subcutaneous fat. If you’ve had children and I’m guessing that you have, the problem is skin, laxity and muscle separation. Those are two variables that are not treated by Liposuction. to treat muscle separation you need a full tummy tuck. A mini tummy tuck will treat skin laxity of the lower abdomen only but will not address bulging abdominal wall due to muscle separation. Were you happy with your abdominal contour pre-pregnancy? If so, issues are not related to fat distribution, but pregnancy related changes. Pregnancies do not change distribution. What you need a seal ass assessment that helps differentiate each of the different tissue variables that determine what the abdomen looks like. Any good plastic surgeon should be able to figure out what’s causing your abdomen to look the way it does and give you a solid treatment plan. Any operation that doesn’t treat the primary problem isn’t going to give you a good outcome. Best, Mats Hagstrom MD