Although it's not your only option, a lipoabdominoplasty (tummy tuck and lipo) that would give you the most dramatic change. The tummy tuck would remove the excess skin from the level of the belly button down to the pubic area from hip to hip. After tightening the underlying muscle, the skin above the belly button extending to just under the breast would be redraped downward to cover the entire abdomen. Liposuction of the flanks, waist, love handles, bra rolls, and back can be performed at the same time to sculpt away excess fat in these areas and improve the curves. A tummy tuck requires general anesthesia and at least a couple weeks of downtime. A tummy tuck also comes with scars which include a low transverse scar, ideally at the level of the bikini line, and a scar around the belly button. If the scars, general anesthesia, and recovery demand is not something that you accept then the next option would be thorough liposuction of the upper and lower abdomen from just under the breast to the pubic area, liposuction of the flanks, waist, lower back, love handles, and bra rolls. This is referred to as a 360. This option would improve your shape and decrease your size but it won't remove excess skin. This option is performed in our office with the patient comfortable awake but relaxed with oral medications and with thoroughly placed local anesthesia. Regarding work and normal activities, the downtime is 2-4 days. The scars are very minimal. With this option, you can always move into a full tummy tuck in the future if the skin is still bothersome. With all that said, a consultation in person is the best way to determine what procedure is right for you.