Non-invasive procedures, lasers, ultrasounds, creams, and other attempts to improve your abdomen’s loose skin will likely be very unsuccessful.
You have done a great job keeping in excellent shape and yet the loose skin bothers you. I have to respectfully disagree that an abdominoplasty would be overkill.
I operate on many ladies who start with limited amounts of loose skin and yet it bothers them.
You work out, take care of yourself, and a surgical solution is certainly possible.
Are there risks? Of course there are. But there are risks in everything and in truth, an abdominoplasty performed by a board certified plastic surgeon is a very common procedure with an excellent safety record.
I would highly suggest meeting with some surgeons in your areas to get true consultations and options. (Evan Sorokin, MD, Cherry Hill Plastic Surgeon)
Based on your photos, you are an excellent candidate for a Tummy Tuck. You are slim and appear to be in good physical shape. You are the kind of patient we like to see.
49 years old is a great age! That is not old, and I am sure you have many wonderful years ahead. Consult with a Board Certified Plastic Surgeon to discuss your expectations and concerns! (Robert E. Zaworski, MD, Atlanta Plastic Surgeon)
I see your frustration, since you look that you are in excellent physical condition. The loose skin and muscle looseness can be repaired via a short scar (like a C-section scar) mini abdominoplasty. This would define your muscles and will put sexy back into your body. 49 is not old by the way. See a board certified plastic surgeon for a consultation. (George Marosan, MD, Bellevue Plastic Surgeon)
Abdominoplasty or not?
A tummy tuck will most likely be your best options. It will get you a flat belly, get rid of extra skin and when I perform tummy tucks I always liposuction the waistline which will give you an even better result. (David Nicholas Csikai, MD, Jacksonville Plastic Surgeon)
Can an abdominoplasty help you reach your goals. It depends on what your goals are. You have loose skin and I cannot tell if your muscles are tight: are the pictures with the muscles tensed or relaxed. You would get an improvement in the skin and muscle issue but be aware that when you bend over you will still have some loose skin (otherwise you would not be able to stand up) The trade off is surgery and scars but you appear to be someone who would get an excellent result. (John P. Stratis, MD, Harrisburg Plastic Surgeon)
Reading your history, and looking at your pics, I can see that your strength layers and skin are stretched, and that you do not have a thick fat pad. Your best option is a full tummy tuck, as the defect extends above your belly button.
Of course, this is elective, and you may choose to do nothing. Laser lipo is an option as it shrinks skin, but I think results will not be great, as you also have a stretched strength layer, and this will not be treated. (Scott E. Kasden, MD, Dallas Plastic Surgeon)
You are in excellent shape with only modest excess skin. It may be difficult to get the skin to pull down enough for best results with a full tummy tuck.
You would need to be examined for best advice, but another option would be a mini lower abdominoplasty and an upper abdominoplasty pulling the upper abdominal skin up under the breasts. (Marialyn Sardo, MD, La Jolla Plastic Surgeon)
I am in agreement with the other physicians as you look like you are in great shape at any age. You appear to be a wonderful candidate for a tummy tuck as it will help you realize your goals for the appearance of your tummy.
From the photos you really have a nice flat abdomen, especially after having such large babies. The non-invasive methods will give some improvement, but when patients show me their excess skin while flexing their abdomen I really encourage them to undergo the full tummy tuck.
If they don’t, they generally are dissatisfied with the outcome because the skin is not tight enough with a non surgical option. Having realistic expectations is key if considering something less invasive than a tummy tuck. (Brian Dorner, MD, Columbus Plastic Surgeon)
Nonsurgical options will only give modest results (if any). Although you can try them (Thermage, and other radio frequency treatments), be prepared to see no result. Based on your pictures, a tummy tuck is very likely to give you the result you desire. (Karol A. Gutowski, MD, FACS, Chicago Plastic Surgeon)