Hello, and thank you for your question regarding whether you will need surgery or if your skin will potentially stretch back, given that you are a 26-year-old male, 162 pounds, and have lost 90 pounds. Thank you for your history and your pictures. In examining your abdomen, you have extra skin and fat that hangs over the belt line. You also have some evidence of stretch marks. The stretch marks indicate that the skin will not reliably bounce back after just liposuction. Therefore, you have excess skin and fat in the lower abdomen, which will probably not contract with liposuction alone. You will need a tummy tuck, also known as an abdominoplasty. A tummy tuck is considered a more comprehensive approach than liposuction alone. During your abdominoplasty, you may need some liposuction around the love handles, but it is unlikely. Therefore, most plastic surgeons who specialize in reconstructive plastic surgery after massive weight loss would suggest that you undergo an abdominoplasty with an incision from the hip to the pubic region to the other hip. At a later date, consider VASER high-definition liposculpting of the abdomen to really define your rectus abdominis six-pack. This is a common staged procedure performed by experienced plastic surgeons who specialize in this field. Good luck. Before embarking on any of these procedures, you should have reached your goal weight and maintain that weight for approximately 4 to 6 months. I hope that I have answered your question regarding whether you will need surgery or if your skin will stretch back, given that you are a 26-year-old male, 162 pounds, and have lost 90 pounds. Most plastic surgeons offer free virtual or in-office physical consultations. Therefore, explore what other plastic surgeons have to say. If you have any more questions regarding tummy tucks, abdominoplasties, or abdominal liposuction, contact an experienced plastic surgeon. Since the tummy tuck surgery is a major procedure, please seek an experienced, board-certified plastic surgeon with significant experience in performing tummy tucks. Do your research. If you cannot find an experienced tummy tuck plastic surgeon in your area, consider traveling to another state for treatment. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS. ( Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic surgery, Fellow of the International Society of Aesthetic Plastic surgery, American College of surgery, and International College of surgery and member of the American Society of Plastic surgery, American Academy of Cosmetic surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.