Thank you for your question regarding what to do about your abdomen and the excess skin around your central abdomen. In my opinion, you would do best with an extended horizontal tummy tuck. However, you did mention that you are concerned about the excess skin and fat of your back, especially when you sit down. If you are concerned about your love handles and back, you will need to convert the extended tummy tuck into a 360 circumferential lower body lift. Therefore, if your buttock bothers you, go all the way around with a lower body lift. If you can live with your buttocks then proceed with an extended tummy tuck. In my opinion, you do not need an inverted T or fleur de lis tummy tuck. I do not think you need the vertical component to your tummy tuck. Thank you for your question regarding what to do about your loose abdominal skin. I specialize in reconstructive plastic surgery after weight loss. If you have any more questions regarding a tummy tuck, lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing the lower body lift. Do your research. Make sure they have performed at least 100 tummy tuck or circumferential lower body lift surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced, tummy tuck or lower body lift surgeon in your neighborhood, consider traveling out of state if you must. 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, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)