Hello. Thank you for your question regarding the best approach to address the loss of elasticity in your stomach skin, especially as you prefer not to have visible scars. Thank you for sharing your pictures. At 55 years old, experiencing loose abdominal skin is quite common. Further liposuction is not recommended as it would likely exacerbate the condition of your abdominal skin. For situations like yours, skin removal surgery, typically known as a tummy tuck or abdominoplasty, is the only definitive way to remove loose, hanging abdominal skin. Tummy tucks address three main concerns: loose skin, excess fat, and weak muscle. In your case, the primary issue is loose skin. During a tummy tuck, the incision is strategically placed low in the pubic region, which usually allows it to be covered by most "reasonable" clothing, including many bikini styles. However, if you are very concerned about having any scar at all and wish to continue wearing a bikini without feeling self-conscious, this might pose a challenge. The reality is that effective skin tightening in cases of significant laxity typically requires surgical intervention, which inevitably results in a scar. If you are adamant about avoiding any scars and are willing to live with some degree of loose skin, then non-surgical treatments might be considered, though they are unlikely to achieve the same results as a tummy tuck. Treatments like J-Plasma or Renuvion, which you mentioned, can provide some degree of skin tightening but are generally less effective for more pronounced skin laxity. Ultimately, the decision to trade your lax tummy skin for a surgical scar is a personal one. It is essential to weigh how much the loose skin bothers you against your feelings about having a surgical scar. I recommend discussing these options further with a board-certified plastic surgeon who can provide a detailed assessment and help you understand what can realistically be achieved with or without surgery. Good luck, and I hope this helps clarify your options regarding your concerns about your abdominal skin. Sincerely, J. Timothy Katzen, MD, FASMBS, FICS Plastic and Aesthetic Surgeon