Do I need lipo 360 or extended tummy tuck? (Photo)

I would start with liposuction to remove the excess fat. Once healed, then you can see if you might need a mini tuck if you have residual lower skin.

Hi 2trilll4u,
This is a common question…will liposuction alone address my concerns?
Liposuction as a way to remove excess fat, from the areas in which it is not wanted. Consideration of the overlying skin is important in any liposuction procedure. In women with poor quality or stretched out skin, liposuction can create an appearance of skin excess, as the previously stretched out skin does not have the elastic capacity to recoil when the fat is removed.
While it is challenging to say from your photos, the lateral photo suggest that you have stretch marks below the bellybutton. Stretch marks skin often has poor elasticity, and would not be expected to tighten well after liposuction.
Stated differently, your surgeon is probably suggesting an extended abdominoplasty because the optimal treatment for the stretched out skin is removal, as opposed to expecting it to recoil after liposuction alone.
I would definitely suggest rediscussion with your surgeon prior to surgery.
Hope this helps.
Hope this helps.
Sincerely,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington