This is difficult to assess without seeing you but it can be safe to perform a limited amount if liposuction on the lower stomach at the time of abdominoplasty. However on an abdominoplasty the lower abdominal skin and fat is often removed so this is not an issue. One must be very careful if doing liposuction of the upper abdomen when also having an abdominoplasty.

Medically speaking it sounds like you qualify for a breast reduction, provided you are otherwise in good health and do not smoke. For those with significant health problems, smokers, or other issues which may affect your ability to tolerate surgery or heal well, you may need to improve your health prior to this procedure. However, this does NOT mean that your insurance company will agree with this assessment. Insurance companies require a certain amount if tissue to be removed based on your height and weight, a certain BMI (within a range of weight for your height), and documentation of your symptoms by your physician, as well as any treatments you have tried to alleviate your symptoms. The more documentation that you have, the better chance you have of approval.