Do I really need a tummy tuck? I want just 360 lipo with BBL. (photo)

Thank you for the question.  Based on your pictures I think that is clear that you will be a good candidate for tummy tuck surgery and will not be pleased with the outcome of liposuction surgery alone.   
Some general thoughts may be helpful to you:
Generally, the tummy tuck operation involves removal of excess skin/adipose tissue of the lower abdominal wall and re approximation of the abdominal wall muscles that may have spread with pregnancies and/or weight gain/loss. Liposuctioning is often used as a tool during the procedure.
Generally speaking, the “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight.
Liposuction surgery, on the other hand, refers to an operation that essentially suctions out adipose tissue. The operation does not involve any skin removal or re approximation of abdominal wall muscles. The best candidates for liposuction surgery of the abdominal wall are patients with good quality skin elasticity and a moderate degree of diet and exercise resistant adipose tissue superficial to the abdominal wall muscle layer. Patients who are significantly overweight, have significant abdominal wall laxity, and/or have lost a significant amount of skin elasticity are not generally good candidates.
My best suggestion: seek consultation with board-certified plastic surgeons who can demonstrate significant experience helping you achieve the type of outcome you will be pleased with. Best wishes.

Thank you for your question. Based on your photo, I would recommend a tummy tuck. This procedure will remove both excess skin and fat to the abdomen, giving you the flattest stomach possible. If you are wanting to avoid having multiple surgeries, and ultimate goal is having a flat stomach and addressing the excess skin, I would recommend performing the tummy tuck with flank and back liposuction, and fat transfer to the buttocks. I recommend discussing procedure recommendations with your plastic surgeon. Best of luck!

You need a formal evaluation by a licensed plastic surgeon and expert in abdominal surgery to determine what is best for you and your goals.
The key to a successful tummy tuck (or abdominoplasty) is to address the multiple layers that are damaged with pregnancies or weight fluctuations. For most patients I will perform internal rectus muscle plication to flatten and tighten the abdominal wall while creating a better waistline. The excess abdominal skin and fat is then excised and tightened, leaving a low, discreet transverse scar. Keeping this scar as low as possible is important so my patients can wear normal bikinis and low-cut jeans. For many patients, I will use liposuction as an adjunctive procedure to further refine the torso.
To accelerate recovery and reduce the risk of complications, I spend extra time placing progressive tension sutures to tack the abdominal tissues down to the abdominal wall and eliminate space for fluid to collect. I also use a medication called Exparel that is a local anesthetic that releases over a 3-day period; by injecting this carefully in the surgical areas, particularly where the muscle is tightened, I am able to dramatically reduce the immediate discomfort associated with abdominoplasties.
Ideal candidates for this procedure are women who have had children or experienced extreme weight loss and were left with excess skin. During the evaluation, we will discuss your needs and identify the best abdominoplasty technique for you.
I suggest consulting with a board-certified plastic surgeon and expert in body contouring. - Dr. Cohen