Thank you for your question regarding whether you need a tummy tuck or liposuction. Because you have excess skin and stretch marks, I believe you’ll get the best results with a tummy tuck. Stretch marks indicate that your skin will not reliably bounce back with liposuction. Therefore, even though liposuction can be done, we rely upon your skin to snap back for an ideal contour with a history of stretch marks. This can be unpredictable. Therefore, I think you would get the best results with a horizontal tummy tuck or abdominoplasty. The abdominoplasty takes about 3 to 4 hours to perform. It includes muscle plication, a recreation of the belly button, lifting and reducing the pubic region, and eliminating excess skin and fat in the abdomen. If you have any more questions regarding a tummy tuck, lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, 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 tuck or circumferential lower body lift 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 lower body lift 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.)