These are not mutually exclusive procedures, matter of fact they are done together more often than not. Based on the recommendations from the previous posts, if you go by the strict criteria, that a person must have good elastic skin otherwise they are not candidates for liposuction, then liposuction would be done only on the few potential patients who fit this criteria. Liposuction would not be the number one procedure in this country or the world. There are many ways to approach a patient with so-so elastic skin, excess fat, loose lower abdominal skin with sagging pubic area, fat rolls on the back, waist, hips, etc. I often liposuction my patients first who are not the best candidates for a TT, then I do a TT six months later to get the best body contouring and hourglass figure. Often, the TT scar is shorter if the liposuction is done first. Even poor skin with stretch marks tightens up to a certain degree. I do all my TT/liposuctions in my accredited office surgery suite under intravenous sedation and tumescent anesthesia. I do not use general or even epidural anesthesia anymore.Lipo is not a good alternative to a TT, but is a procedure that further improves your body contour. Based on your limited frontal photo, you will need a full TT (tightening the muscle from the breast bone to the pubic bone). A mini TT is rarely done, basically on a person with minimal skin laxity and a small fullness in the lower abdomen only. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in pewrson consultation/evaluation. good luck.