Nothing substitutes for a personal evaluation and a face to face discussion of your options. Unfortunately without a examination I can advise you in general terms, however I hope you will find them helpful.
In general it’s best to be a your goal weight prior to surgery:
1) your abdomen (and other parts of your body) often will change size with weight fluctuations.
2) we all have internal fat (fat on our internal organs that pushes out the abdominal wall and not accessible to liposuction or abdominoplasty) and external fat (fat that we can pinch between our fingers that can be liposuctioned or surgically removed during abdominoplasty). Weight loss effects both and thus when you attain your goal weight we can optimally tighen your muscles and remove the excess fat and hanging skin.
3)Body Mass Index (BMI) over 30 and greater is associated with progressively slightly increased complications.
I would perform two stages for safety, pain control and overall I feel better long term result.
First Stage:
1)Extended abdominoplasty: removing all skin and fat between your pubic hair line (or lower) and your umbilicus (tummy button) which would remove most if not all of your rolls of abdominal skin.
2)tighenting your presumed separated muscles.
3)Liposuctioning your flank areas4)insertion non-narcotic paint pump for post op pain control
Second Stage (3-6 month latter)
1)lateral thigh and buttock lift
2)aggressive liposuction of abdomen, thighs and back
3)insertion non-narcotic paint pump for post op pain control
I believe you are a reasonably good candidate and will be very satisfied with your extended “tummy tuck” and its components as stated in above.
Sensation usually returns after liposuction. You most likely will have a area of decreased sensation just above your central abdominal incision (Similar to women after c-section).
I suggest you make out a list of your questions and select several nude “model” photos of what your desired goals/look would be and then schedule several different consultative appointments with experienced Plastic Surgeons who are Certified by the American Board of Plastic Surgery and who are ideally members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).