Liposuction or tummy tuck
There are three things real plastic surgeons look at in this case. The skin, fat, and muscle layer(fascia) of the abdomen. Liposuction, with laser or not, will only remove fat.
Contrary to what you may hear, laser lipo does not tighten skin. It only induces scar formation. A Tummy tuck or abdominoplasty will address all three.
Unfortunately a scar is unavoidable. In most instances you will find the scar is a small consolation for a flatter, tighter tummy. (Randy Proffitt, MD, Mobile Plastic Surgeon)
A tummy tuck is certainly not your only option, but it definitely appears to be your best option. It appears that you have a good bit of muscular laxity in your central abdomen and also that you have significant striae or stretch marks in the lower abdomen. Only a tummy tuck will address these two areas. (John Whitt, MD, Louisville Plastic Surgeon)
In women who have had a couple kids and are left with extra skin and rounder belly the best option remains tummy tuck. If there is not a lot of extra skin then a mini tummy tuck may be in order. Either way, the rectus muscles usually need to be tightened as well. In San Antonio, I find that most women need a full tummy tuck. (Suresh Koneru, MD, San Antonio Plastic Surgeon)
Given your history and photos, you would be a good candidate for tummy tuck. Tummy tuck is a great procedure for most moms with excess skin/fat and stretched out muscle. For all moms, our rectus muscle stretches during pregnancy along with belly skin. Unfortunately, even if you lose all the fat from the tummy, you would still have excess skin stretched out muscles. Therefore, tummy tuck is the only procedure to get rid of the excess skin/fat and to tighten the muscle. There really is not a good alternative for tummy tuck. Liposuction can get rid of fat but not skin. (Sugene Kim, MD, FACS, Houston Plastic Surgeon)
The best procedure for you would be a tummy tuck. This procedure would tighten your skin but also tighten the underlying muscles. Without addressing your muscles, your belly will still have a round appearance. Without tightening the skin, your stretch marks would still be present. (David Shafer, MD, New York Plastic Surgeon)
From your photo and this is not the same as an in person exam, you look like you need a full tummy tuck because of muscle laxity and skin excess. Liposuction alone will not help. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)
I do not think there is an equivalent substitute of a tummy tuck for you. If you choose not to have a tummy tuck do nothing at all, liposuction, etc will not offer much improvement (Vishnu Rumalla, MD, Dallas Plastic Surgeon)
Is a tummy tuck my only option?
Without examining you and going only by your photos, you appear to have excess or loose skin and particularly stretched fascia and abdominal muscles. There is no other procedure, other than a tummy tuck, that will tighten your skin and repair/tighten your abdominal muscles and fascia. For most people who have this degree of laxity, it is well worth the scar. But only you can answer that. (Robert M. Grenley, MD, Seattle Plastic Surgeon)
Unfortunately, if you have the physical changes that a tummy tuck corrects, as you do, none of the alternatives will give you the result you want. I see several patients a year that went somewhere and had Smartlipo or some other variation and still need the tummy tuck and could have saved all that time and money. Only you can decide if the tummy tuck scar is worth the change, but there is no other way to get the change. (Ronald V. DeMars, MD, Portland Plastic Surgeon)
Only tummy tuck for diastasis and loose skin
Unfortunately after pregnancy the skin is quite loose and there is considerable laxity in the stomach muscles which only the tummy tuck will correct. The scar can follow the c-section and stay low. Liposuction just will not provide any meaningful solution. (Peter E. Johnson, MD, Chicago Plastic Surgeon)