Weight fluctuations my whole life - what procedures would you recommend for my lower back, buttocks and thighs? (Photos)

I’m 32, 5” 9’ and 165lbs. In 2023 i was 228lbs at my heaviest. I have been on/off ozempic for 3 years now which contributed to the 60lb weight loss. over the course of my teens to 20’s i had gained and lost 40-60lbs regularly. I 2018 i had a 25cm adnexal mass removed from my ovaries and i lost 25lbs in less than a week. I weighed 190lbs at that time and maintained 190lbs for 2 years. I quit drinking and gained weight rapidly, ending st 228lbs. my lower back, buttocks and thighs have had this appearance since 2016. in 2014 i weighed 150lbs which was the smallest i had ever been. I had a breast augmentation and by 2015 i was 200lbs. In 2018-2019 i was doing 5 spinning classes a week and working out routinely. I didn’t lose a single pound but my body changed slightly. I have since given up as this has been a struggle my entire life. Where do you go from here? What procedures? What’s next?! Any advice is suggested