I had liposuction almost 10 years ago and I have a “donut” around my stomach. what can be done to fix the unevenness? (photo)

Hello.
Great question. Thank you for your pictures. It appears you may benefit from a full tummy tuck procedure to give you a flat appearance. Due to your skin laxity, liposuction alone may not achieve your goals. Please visit a board certified plastic surgeon for a detailed surgical plan to achieve your desired results. 

Go get liposuction again and have them do Bodytite at the same time and you will be just fine.

this needs a tummy tuck with revision liposuction for the best results.
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.

Skin tightening (dermo-lipectomy, tummy tuck) is the best method for significantly smoothing abdominal skin surface irregularities after liposuction, after pregnancy, or after both liposuction and pregnancy.  Abdominal skin is naturally soft and flexible.  Removal of fat beneath skin by liposuction further loosens abdominal skin causing it to sag and creating uneven surface contour.  Tummy tuck mobilizes skin attachments contributing to irregularity, repositions skin for a smoother, tighter surface, and removes excess loose skin.  Several examples of liposuction irregularity (much worse than yours) improved by tummy tuck in our online gallery.

Dear CaliLove00,
I would have to examine you but it appears that this is a contour irregularity after liposuction.  This happens often when areas the undergo liposuction are not feathered appropriately. The good news is that it can be fixed and I have done so with good results before. 
While there is always a chance for contour irregularities with liposuction, someone who takes their time and uses the appropriate sized cannulas should give you a superb result.I have all my patients wear compression garments and I use multiple sized cannulas to feather out the result.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your photos. You will be best served with revision liposuction to clean up the areas of fat in the front abdomen as well as a tummy tuck to stretch and smooth out the skin. The wrinkling and lumpiness of the area around your belly button is mostly due to skin which cannot shrink anymore. Your stretch marks also demonstrate that your skin has lost its ability to tighten on its own. This excess loose skin will be removed during your tummy tuck and your muscles tightened for an even slimmer look. Hope this helps!Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

An ultra high definition tummy tuck would be the best solution. This procedure would help address the excess skin and fat in the abdominal region. High definition VASER liposuction of the flanks and back will also help create a pleasing, natural aesthetic. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.
Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee