You're in really solid shape now, but honestly the skin probably won't tighten much more from here. Keep that weight steady for a while and live with it before deciding what's next. I lost over 300 and eventually got plastics, then regained 150 and lost it again - could do another surgery but haven't yet. I know the struggle. Depending where you are, teaching hospitals in the UK might offer cheaper options since they train residents. Medical tourism in other countries is also a thing.
bmi charts are based on white dudes only. even thin i was 'overweight.' only time i hit 'healthy' was running myself ragged—full job, college, house reno, babysitting on weekends. looked awful, felt awful. at my best around 160–170 but that's another story.
Got down to 176 after stacking compounded tirz and reta - took two and a half years to get here from 325. Now I'm at one milligram of each weekly to hold around 180. Mid-fifties and honestly feeling better than I have in decades. The slow approach worked better than chasing numbers fast.