Hello and thank you for your question. From the picture you have provided, you have some striae (stretchmarks) present throughout your mid and lower abdomen, and a moderate/severe amount of excess subcutaneous fat and skin present in this region and extending laterally to the anterior/mid flanks. There is minimal relative adiposity (excess skin/fat) to the upper abdomen. Based on all this, you would benefit from an abdominoplasty (tummy tuck) and flank liposuction to best help improve your abdominal/trunk contour. The difference between a "standard" and "extended" tummy tuck is just how far your incision extends to the side, and this is based on how much excess skin and fat needs to be removed to produce an aesthetic contour. They are essentially the same procedure, so no need to be concerned here. Generally, every surgeon tries to keep their incisions as short as possible so they can be easier hidden, but the goal here is ideal body contour at the expense of scars, so this is important to keep in mind throughout the process. Regarding the transverse lower abdominal scar, it should be well hidden within your bikini or underwear, and if you adhere to proper scar care and sun avoidance after surgery, it should eventually heal to be minimally noticeable. Liposuction is a great adjunct which would provide some additional benefit, particularly to the contour of your flanks, and would be done at the same time as your tummy tuck procedure for the best possible single operation results. With all that said, it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from any photos and descriptions provided. I recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps! Best wishes, Dr. Donald Groves Plastic Surgeon