No doubt, you will need to excise the excess. What your photos do not show is if the excess comtinues around your flanks and across the lower back.
If this is the case, then a trunkplasty, or lower body lift, may be needed. If so, plan to do it at the same time. (Robert H. Schnarrs, MD, Norfolk Plastic Surgeon)
Forget liposuction as you have extra skin and rolls of lax skin. Only a tummy tuck will address these issues but you need to decide if it is something you want to have, scar and all. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)
Tummy tuck after weight loss
In most cases, the skin cannot retract enough after being stretched so far. It is likely that you would benefit from a surgical procedure (an abdominoplasty) to remove the extra skin and create a smoother, tighter contour.
Consulting with a plastic surgeon will give you the answers you need to determine how far the incision will need to go and what you can expect as a result. It sounds like you are a great candidate for surgery since your weight has been very stable. (Michelle Spring, MD, Los Angeles Plastic Surgeon)
Tummy tuck? after two years of loose skin
If it has been two years and the skin still hasn’t snapped back, then it probably isn’t going to. From the pictures you’ve included, you appear to be an excellent candidate for a tummy tuck. You may be a good candidate for a circumferential tummy tuck that extends around the back and lifts the lateral thighs/hips, back and buttock. This is called a lower body lift or a belt circumferential abdominoplasty. Make sure that you see a board certified plastic surgeon for a complete and thorough evaluation. (J. Jason Wendel, MD, FACS, Nashville Plastic Surgeon)
You will have an excellent result as long as you also have a transverse plication of the rectus abdominis muscles. With the 160 lb weight loss, it is likely that your muscles have been displaced laterally by your previous internal weight gain.
Now that you have lost that weight, the muscles will probably need to be repositioned back to the midline with sutures.
This is easily included during the removal of your extra skin, using a transverse spindle shaped skin removal template. Be sure you consult with a Board Certified Plastic Surgeon. (David N. Hing, MD, Ann Arbor Plastic Surgeon)
Tummy Tuck Candidate?
I think you are an excellent candidate for tummy tuck surgery. You should consider whether you should undergo a full tummy tuck procedure or an extended tummy tuck procedure. The tummy tuck procedure will serve to remove “excess” skin and adipose tissue and plicate (put back together) the abdominal wall muscles that spread when you were heavier.
Raising the pubic area may also be helpful. Extended tummy tuck surgery may be helpful for some patients who are concerned about the “muffin top” or “love handles – (flank or lower back skin and adipose tissue). Treatment of the stubborn muffin top involves excision (lipectomy) of excess skin and adipose tissue. Liposuction surgery alone will potentially leave the patient with loose skin and an unsatisfactory result. (Tom J. Pousti, MD, FACS, New York Plastic Surgeon)