To some extent the answer depends on your expectations. from the photos provided there are some stretch marks and loose skin, particularly on the lower abdomen. If you want skin tightening you may not get the desired result with liposuction alone. However if you just want an improvement in contour it might be enough. (William Andrade, MD, Toronto Plastic Surgeon)
Tummy tuck is the best procedure
you look like you have some extra skin because of your pregnacies, you can also request about a less invasive procedure like a mini tummy tuck, it doesnt matter which of these two procedures you choose you can be sure that the results will be very good. (Australia Fragoso Baez, MD, Dominican Republic Plastic Surgeon)
It appears that you have the extra skin and laxity after your children for a tummy tuck. There are no other procedures that replace this operation so do not waste your money. You may need a short vertical incision as your belly button a bit higher.
You can always move the incision up and no vertical but then the scar may show more in some outfits. (Gregory T. Lynam, MD, Richmond Plastic Surgeon)
who is a good good candidate for Tummy Tuck?
I’m constantly surprised of the amount of loose skin that is present following multiple pregnancies. There is a good possibility that you would benefit from a full tummy tuck . I prefer a W type incision instead of the vertical component. This allows a shorter horizontal incision and facilitates the closure of the incision in general. (Thomas Trevisani, Sr., MD, Orlando Plastic Surgeon)
Given your concerns, previous pregnancies, and loss of skin elasticity, I agree that abdominoplasty may be best-suited for you to achieve your goals. Liposuction depends on skin retraction post-operatively to improve contour after removing excess subcutaneous (fatty) tissue. If skin has lost elasticity (which is common after pregnancies or significant weight loss), liposuction is not recommended since it will likely result in incomplete retraction and significant skin redundancy.
Abdominoplasty addresses the rectus diastasis (muscle separation in the midline that commonly results following pregnancies, likely to a greater degree after twins) by suturing the rectus muscles back together to reinforce core strength. It also removes excess skin and soft tissue through an incision along the lower abdomen from hip to hip, which improves abdominal contour. I recommend consulting with a board-certified plastic surgeon to determine whether you are a good candidate for abdominoplasty based on a complete medical history and clinical examination. (Stephanie Power, MD, MSc, FRCSC, Toronto Plastic Surgeon)
Is a tummy tuck my only option
I don’t believe so. I think liposuction alone will give you a nice improvement. You will get an even better improvement with a combination of a tummy tuck with liposuction the compromise being your scar. To keep your tummy tuck scar as low as possible (I believe best for patients) because you have an attractively high belly button now, you will most likely need a short vertical incision in the midline low on your pubis. (Peter Fisher, MD, San Antonio Plastic Surgeon)
Lateral tension abdominoplasty tummy tuck
Unfortunately pregnancy especially large pregnancies including twins can cause weakness and separation (diastasis recti) of the abdominal wall and muscles. This can only be addressed with an abdominoplasty, in my experience, lateral tension abdominoplasty tummy tuck uses an extremely low hidden scar contor this region entirely. (Kevin Tehrani, MD, FACS, New York Plastic Surgeon)