Remove Excess Skin and Fat Inplace of Tummy Tuck?

Judging by your photo, you would probably benefit from a full tummy tuck. It would remove the excess skin and fat, as well as tighten any weakened muscles you may have from pregnancy. Some of your stretch marks would also be removed. You would have to have an in-person consultation with a board certified plastic surgeon for a better evaluation of your concerns and the cost.

You can have just the excess skin removed but tightening the muscle is helpful in allowing more lax skin to be removed in addition to flattening the tummy.  Also without muscle repair the tummy will remain pouchy.

Dr. ES

The tummy tuck helps with three problems on the abdomen after pregnancy. 

1) Loose Skin - Excess and loose skin are removed with a tummy tuck, there is no other way to get any significant tightening of the abdominal skin.

2) Excess Fat - The majority of excess fat on the abdomen is found below the belly button. When the lower abdominal skin is removed, this fat is taken away with it. Lateral fat (around the sides) can also be safely removed with liposuction at the same time as a tummy tuck.

3) Loose Muscles - Bulging of the entire abdominal wall is caused by muscle laxity. This allows the guts to fall forwards and make the belly look round.

In most cases all three need to be done for optimal results. Before ruling out muscle tightening, it would be best to see a Board Certified Plastic Surgeon in your area, and see what the risks and benefits will be for you.

I've included a link below that reviews many of the common questions about tummy tucks, and a video (part 1 of 3) about tummy tuck surgery.