Hello, littlebowpeepboob, thank you for your history and questions regarding whether you need a tummy tuck or lipo. Most plastic surgeons would agree that you need an abdominoplasty or tummy tuck. You have too much excess abdominal skin for a successful tummy liposuction. Even if you use state-of-the-art VASER liposuction with radiofrequency (RF) for maximum skin contraction, you will still probably be left with tummy wrinkles and hanging skin. Therefore, you would be a much better candidate for an abdominoplasty or tummy tuck. During an abdominoplasty or tummy tuck, an incision is made underneath your abdominal skin fold, and tissue dissection is carried up to the rib cage. Your rectus abdominis muscles are plicated. The skin and fat from the top of the pubic region to the bottom of the belly button are removed. The belly button is reconstructed. The pubic region is raised and reduced. You could do additional liposuction in the upper abdomen and the flank region to maximize your abdominoplasty. However, if you only have tummy liposuction, you will be left with excess abdominal skin. I hope this helps you to clarify what surgery will be best for you. Again, most certified plastic surgeons would suggest undergoing abdominoplasty or tummy tuck and not just lipo of the abdomen. Good luck. 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 big 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 neighborhood, consider traveling out of state. 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.)