i disagree with many of the providers here, I used renuvion and body tite for a year before ANYONE and did 100s of cases with much much better results than liposuciton alone. they say its not better because they dont know how to use it. and I dont need to promote the device I use it because it givds much better results. the bottom line however, is that you need back lifting, mini tuck, and at least a mini brachioplasty. if you do not do these skin removals because of scars or bigger procedures, liposuction + j plasma/renuvion will give you improgement but your back and arms will have some sagging and crepe skin and the stomach will be better but may have looseness when you bend forward. I suggest seeing an expert and I also think that you need hormonoal optimization for weight loss and skin tighteing (see link). You need a formal evaluation by an expert in body shaping and contouring to determine what is best. Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring. Small problem areas can be improved slightly by these methods. The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring. This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face. Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra. If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty). Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting. Dr. Emer.