Dear 40'ish, Front and side view pictures would have been very helpful. The firmness of the skin is not as important, in tummy tuck surgery, as much as the skin laxity. If your skin is tight, all it means is that , most likely, you will have a small vertical scar in the low mid abdomen , which is the old belly button location. Other than that, you should have flat stomach with tight and youthful looking skin, nice belly button and improved body posture, like any other tummy tuck. As far as combining tummy tuck with liposuction, it is not a good idea, due to significant increases in severe complication. In a recent article in the plastic surgery journal that was based on data from cosmetic surgery only insurance company, it was revealed that combining tummy tuck with liposuction surgery increases the severe complication rate X 10 in comparison to tummy tuck surgery alone. Also, in Florida, it is illegal to perform tummy tuck with liposuction surgery of over 1000 cc, which is a relatively small amount, due to severe complications including multiple deaths that were revealed in state investigation... Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with the above mentioned features and low scar. Best of luck, Dr Widder