Thermage or tummy tuck, which would improve my saggy skin and belly fat? (Photo)

Hi. Thanks for your question and for providing a photo. The answer really depends on whether you want the loose skin above the umbilicus (belly button) completely gone or not. You would get some improvement from a combination of liposuction, followed by Thermage for the loose skin above your belly button, but this will not completely remove the loose skin at the umbilicus - if you want this removed then you need to have a tummy tuck (abdominoplasty). An abdominoplasty does leave a scar (which can be hidden under normal underwear), but gives you a completely flat contour. Look at the photos on the link below - if you have further questions please send an enquiry via my website, or I would be happy to see you to discuss things. Dr Charles Cope 

The photo that you provided helps address this question best.  I would suggest Coolsculpting by Zeltiq which will help reduce the bulge in the belly in an easy painless non-invasive manner.  After your Zeltiq treatments, I would follow-up with Thermage to tighten the skin around the abdomen.  For the best results please consult a board certified dermatologist with a great deal of experience since these procedures are very technique dependent.

A Thermage treatment would improve
your lax skin; it would not however treat “belly fat”.

A Thermage Abdomen treatment is a non-surgical
procedure that is clinically proven to be safe and effective with No downtime.
You will see some immediate results off the table with continued improvement
for six months after treatment as your skin continues to regenerate collagen
and thicken its collagen matrix resulting in a smoothing effect

In my office I offer two types of
treatments for unwanted fat, Coolsculpting or Liposonix. If you can pinch an
inch then you might be able to do either Liposonix or Coolsculpting, both are
non-surgical body contouring options.

Liposonix uses High Intensity Focused
Ultrasound to destruct the fat, while Coolsculpting utilizes cold to destruct
the fat. With Liposonix you can lose approximately 1 inch in 1 hour with 1 treatment.

With
Coolsculpting you can lose about 20%/30% of the fat treated. Either option is
not going to yield immediate results as the body has to naturally remove the
treated fat. This generally takes 8-12 weeks to be completed.

For best
improvement I would recommend either Coolsculpting or Liposonix followed by
Thermage, so both of your concerns are addressed.

Consult with
a Board Certified Dermatologist to see which treatments are best for you.

I think Thermage wouldn't be enough, but a tummy tuck would be overkill!Thermage won't treat the fat.  A tummy tuck would leave a large scar, and you just don't have enough fat to justify that.Small, localized fat deposition like in the photo responds best to liposuction (best option) or Zeltiq (cryolipolysis, completely non-invasive fat removal).Best, Dr McNeill