Full Tummy Tuck (Abdominoplasty)
You have a choice between a potentially GREAT looking tummy by having a full tummy tuck (Abdominoplasty) or a mediocre to poor result by having Liposuction and a Mini-tummy tuck.
From the photograph, you have a significant amount of excess skin below and above the belly button. The pooch demonstrated is actually minimized because you are NOT fully relaxed (the vertical line of a still contracted external oblique muscle is clearly visible). If you relaxed to the point that that line was no longer visible, you would demonstrate a classic "hammock sign".
I strongly recommend you have a full tummy tuck with liposuction of your hips to accentuate the upper buttocks.
To read everything you need to know about Tummy tucks and Mommy MakeOver procedures, follow the informative link below -
Dr. P. Aldea
Tummy tuck vs. liposuction
As my colleagues have stated, for loose skin above the belly button, a full tummy tuck will give the best result.
For loose skin below the belly button, either a mini lift or a full fascial tightening with modest skin removal may be an option.
Lipo-Abdominoplasty is the way to go
After reviewing your photos I would recommend a LipoAbdominoplasty. A LipoAbdominoplasty is a full abdominoplasty with lipolysis of the whole abdomen performed at the same time. This will significantly improve your contour and tighten the loose skin and muscles at the same time.
Lipolysis with or without a lower abdominoplasty would leave loose skin above the navel. Don't compromise your results go for the full surgery
Liposuction vs. abdominoplasty
Patients must always expect some degree of skin rolls or laxity when flexing at the waist. Your photos suggest both excess fat and skin. What you decide on depends on what your goals are. If you want tighter skin, you will need a full abdominoplasty. If you are just concerned about the contour, you can do liposuction as a first stage since aggressive liposuction in combination with a full abdominoplasty has a higher risk of complications. I suspect that you will have significant laxity of the skin above the belly button with liposuction alone.
Tummy Tuck will give the best results
From your photos, a tummy tuck would give by far the best results over liposuction alone. You will be disappointed with the liposuction results alone.
A full tummy tuck is what is needed
I join my other collueges in advising you to get a full tummy tuck. There is no way to improve the loose skin above your belly button without a full tummy tuck. Instead of having a small operation which will only leave you disappointed and needing a second operation you should just plan on having the right operation from the start.
Happiness with mini-abdominoplasty
You are primarily a candidate for a full tummy tuck. For you, doing less will not give you a good enough result to make it worthwhile. You will have spent time and money and not be where you really want to be. I have seen patients do the lesser procedure, not be happy and end up spending additional time and money to do the right thing.
Tummy Tuck versus Liposuction
Based on your pictures, you would benefit the most from a full abdominoplasty and liposuciton. Liposuction alone would have little benefit on your loose skin. Good luck.
Don't compromise when treating globally loose skin on the abdomen
You have got loose skin above and below your belly button. Anything less than a full tummy tuck would leave you with laxity exactly where you don't want it: above your belly button. Don't compromise on a lesser procedure because it may offer less 'downtime' or a shorter scar. The consequence of not getting the right operation the first time is a second revisional operation down the road. Make it 'one and done!'
Lipo with skin excision not a good option
Liposuction with skin excision in the lower abdomen is not much different than a mini-abdominoplasty (mini-tummy tuck.) The only difference is that there wouldn't be any tightening of the muscles if they are separated. (If that is the case, no amount of exercise will pull them together since the muscles contract vertically and the separation is horizontal.) In either case, the picture shows skin laxity above the belly button and it will be even worse with fat removal by lipo. The full tummy tuck is the only good option for you based on what I see in the photo. It will be worth it!