Flabby midsection dilemma.

Patient : As the result of a large weight loss 4 years ago (from 195-130) due to a health issue (which has now been resolved) I still have a lot of loose, flabby skin around my midsection. I have been working for 18 months to firm the skin back up...increased water intake, exercising, increased Vitamin E, mineral sat baths,etc. I have not seen even the slightest improvement, even though I have regained back up to 155 pounds. What can I do to FINALLY tighten that skin back up?
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