Hello, and thank you for your question regarding whether a tummy tuck or liposuction would be the best approach to improve your abdominal skin texture after ultrasonic cavitation and CoolSculpting. I appreciate your history and the pictures you provided. Based on your images, I strongly advise against a full abdominoplasty (tummy tuck) and instead suggest VASER liposuction to refine and smooth the area. Since you are young, have no stretch marks, and do not require rectus abdominis muscle repair, most experienced plastic surgeons would agree that a tummy tuck is unnecessary. Your skin elasticity appears to be intact, which means VASER liposuction combined with skin-tightening technologies could be the best option to target stubborn fat and improve the skin’s appearance without the need for a long scar. For the best results, I recommend considering abdominal etching or selective sculpting of the vertical rectus muscle insertion lines, including the linea alba and semi-lunaris lines, which would create a more toned, athletic look. Before moving forward, schedule a consultation with a board-certified plastic surgeon who specializes in VASER liposuction. Bring reference photos of the abdominal aesthetic you want to achieve—this will help your surgeon understand and tailor the procedure to your goals. If you have any more questions regarding VASER liposuction, body contouring, or skin-tightening procedures, I encourage you to consult an experienced plastic surgeon. Since VASER Hi-Def liposuction is a specialized procedure, it’s crucial to seek a board-certified plastic surgeon with extensive experience in high-definition body sculpting. Be sure to research their work, review before-and-after photos, and check patient testimonials on platforms like RealSelf. If you can’t find an experienced VASER Hi-Def liposuction surgeon in your area, consider traveling out of state to ensure you get the best possible outcome. Best of luck on your journey to achieving your ideal aesthetic! Sincerely, Dr. Katzen, MD, MBA, FACS, FICS, FASMBS