Liposuction alone of the abdomen will remove the excess fat under the skin, but the amount of skin tightening following healing will be less than optimal due to your stretch marks and the laxity of the abdominal skin, especially around your belly button. If you want the most aesthetic outcome for your abdomen, both in terms of belly button shape/contour and skin tightening, you will require some sort of abdominoplasty, whether a "mini" which consists of thorough liposuction and skin removal of the lower abdomen, leaving the belly button alone, or a "full" or "formal" abdominoplasty which consists of liposuction, abdominal wall muscle tightening and making a new belly button. Nonsurgical skin tightening procedures to which you referred in you question, whether it is radiofrequency, ultrasound, or a combination of the two can demonstrate impressive results in SOME patients, but unfortunately no one knows which patients which experience the 75% improvement . These impressive improvements are the before & after photos the company whose product they are promoting like to use, not the other high percentage of folks who experience quite disappointing results with some of these modalities. J Plasma , laser and Ultrasound assisted Liposuction ( UAL, "Vaser") all can add additional skin tightening during the liposuction procedure, but even these add-on liposuction modalities may not smooth your skin to your expectations, and YOUR expectations are paramount in obtaining results which will make you happy. If you want to achieve results which will return your belly to the condition closest to what it might have looked like before giving birth, the most reliable and most powerful tool in the surgeon's armamentarium is skin excession. The scar can be hidden well within the skimpiest bikini bottom (no, probably not in a string bikini, but you have to be realistic). You have to be honest with yourself and your surgeon as to what you truly hope to achieve. Unfortunately, if your want a BBL, I do no think it prudent to combine anterior body procedures with a BBL because of the potential safety issues to the buttock skin, grafted fat survival, and even potential pulmonary embolism with fat grafting of the buttocks. Yes, surgeons can sometimes get away with combining these procedures, but I would never accept the one time where the potential safety risks turned into real life adverse patient outcomes. Also, you can always have the abdominoplasty performed at a second stage after you have healed from the liposuction /BBL procedure if you are not happy with how your abdominal skin appears after liposuction and any other skin tightening procedures you may choose. You are not "burning any bridges" as we like to say by not having an abdominoplasty at the time of your liposuction.
