You appear to be a very good candidate for a tummy tuck. Look at reviews and before and after pictures as well as credentials to select your surgeon. (Kenneth B. Hughes, MD, Los Angeles Plastic Surgeon)
Can working out tighten the loose skin on my tummy?
The skin that surrounds our bodies is best thought of as a “skin envelope”. What ever is going underneath the skin envelope the skin will contour to and show.
This assumes that the skin envelope is of good quality, i.e. good elasticity, strong dermis ( the leather portion of our skin), thick dermis, no sun damage.
Unfortunately in your case the envelope is significantly damaged. As a result it will not be able to contour to what is going on below, i.e. strong well form muscles. You truly need an abdominoplasty, and expect you would do very well. (Stephen M. Davis, MD, FACS, Green Hills Plastic Surgery)
Due to the amount of loose skin on your tummy, I agree that you are a good candidate for tummy tuck. nfortunately, no amount of crunches or other activities will smooth this skin.
The good news is, once that skin is surgically removed, the muscles that you have beneath it will finally reflect all of your hard work and give you an even better result if you choose to work out either before or after your procedure. (Steven Vath, MD, Denver Plastic Surgeon)
You clearly need a lot of skin excision to cut away skin with wrinkles. If, on exam you have enough upper abdomen laxity for a full tummy tuck, the wrinkles that are now above your belly button will be shifted down to be just above your pubic area.
But your skin looks damaged, so those wrinkles that are shifted down will still be somewhat visible, although lower on your abdomen. No amount of working out will remedy your loose skin, and actually, fat loss within the area will likely make it appear worse. I have also been performing laser lipo for 6 years and I would not consider you a candidate for lipo only. You need a tummy tuck.
You need a formal tummy tuck that addresses skin, fat, muscle, and belly button. Liposuction alone will do basically zero for you. Even a full tummy tuck will not get rid of all of your stretch marked skin.
Do the tummy tuck and follow your husbands advice and body build which is always a great idea. (George Commons, MD, Palo Alto Plastic Surgeon)