Do I need surgery or do I have other options?

Most surgeons will not operate on a patient until their weight is stable with the diet and exercise regimen that patient is on. Even if not at your 'ideal' weight, many are understanding and willing to schedule you for body contouring as long as your BMI is under that surgeon's maximum. A big 'nasty' scar is always possible with body contour procedures after presumed massive weight loss and you should anticipate that as well as potential healing complications. Muscle cutting is never done with body contouring. Best to invest in a consultation or two with board certified plastic surgeons and realize that you should anticipate the need for revisions so its imperative you know what your surgeon's policy is before scheduling with that surgeon.

Congratulations on your weight loss. Usually when an individual loses a large amount of weight they are left with an abdominal pannus (overhanging skin). The only way to manage this excess is by surgical removal. In many cases the muscle does not need to be addressed. I recommend a consultation with a Plastic Surgeon in your area.