What is the best treatment for my stomach fold - non-surgical skin tightening or a lift? (photos)

From your photos it doesn't appear likely you'd get resolution of your concern with non surgical approaches due to the amount of skin laxity. You may have improvement with BodyTite but an in person exam would be needed to determine if you are a candidate. You can consider a tummy tuck which would address the skin, but obviously that is a surgical correction and will require a scar.

Thank you for your question regarding what to do with the skin around your umbilicus or belly button. This is a horizontal skin fold around your belly button which is more prominent. This is excess skin and excess fat. The excess skin around your belly button may have collected for multiple reasons. This can include genetics, a history of significant weight loss, diabetes, smoking, radiation damage, and pregnancies. Whatever the cause, you have excess skin and or skin that won't bounce back due to the disruption of the elastic fibers within the skin. Therefore, you need skin tightening around the umbilicus. The dermal roller will not do it. Your best option is an abdominoplasty or tummy tuck. This procedure eliminates excess skin around the umbilicus. All other techniques pale in comparison to the definitive treatment of your excess abdominal skin. If you undergo liposuction whether it's VASER lipo or laser lipo, cool sculpting, or a variety of other fat removing techniques, this will eliminate the support for your overlying skin. By eliminating the support, specifically the fat, the skin folds around your belly button will become worse. Therefore, minimally invasive fat-removing techniques will actually make your condition worse, not better. Remember, your issue is excess skin, poor skin elasticity, and poor skin recoil. The skin needs to be removed. I'm sorry this may not be the answer you wanted but this is the reality. You are wasting your money with techniques other than an abdominoplasty. Thank you for your question regarding what to do with excess skin around your umbilicus.

Sincerely, Dr. Katzen.
(“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

You have pretty much only one issue: saggy Skin. You do not have excess of fat. You must acknowledge that a mild degree of saggy skin at certain age, will not get any tighter after certain procedures (any kind of liposuction, coolscultptong massages, AHA etc), only by skin resection. So you are indeed a perfect candidate for a Tummy Tuck and probably muscle repair. And the incision is determined by the need of skin resection based on your degree of saggy skin. The scar is easily hidden under clothes, saggy skin can not be hidden at all. Be encouraged!!Dr. Cárdenas

Dear metrak,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

There is no non surgical treatment that will change your abdomen appearance as much as you are looking for. If you have excess fat it could be liposuctioned at the same time. Then scar is hidden below your underwear. Discuss in person with a plastic surgeon. Good luck.