Pasadena Tummy Tuck doctors

The C-section usually does not result in the rectus muscles being cut -- although the skin incision is transverse, the muscle underneath the skin is separated vertically and preserved.  Although your rectus muscles are preserved, it is very likely that you have developed a "diastasis" or separation of the rectus muscles due to your previous pregnancy.  This is very common and can result in a "pooch" or "bulge" of the lower abdomen.  A key component to the tummy tuck procedure is tightening the diastasis with suture that runs from below the breast bone to the pubic bone.  This is called "plication" and is combined with the removal of excess skin and fat via the tummy tuck incisions.  Plication is a key step in achieving improved shape with additional support to the abdomen.  I describe it to my patients as an "internal corset" that supports your abdomen and helps create a more pleasing contour.  Plication does add a bit more discomfort to the recovery process -- many patients describe the feeling of being "tight" for several weeks following surgery.  This sensation of tightness will relax with time.  Good luck with your future surgery!  Just make sure you have a board-certified plastic surgeon help you achieve your goals.  

You are not a candidate for a panniculectomy since you problem extends well above your belly button.  A panniculectomy removes only the tissue hanging over the pubis and leaves the belly button intact.  If you do not or can not lose weight first, then a full abdominoplasty is the only correct option in my opinion.

You are correct that a full abdominoplasty will go all the way up to the rib cage.  However, the fat that existed above the belly button before surgery cannot be excessively romoved during the standard abdominoplasty without the risk of inturrupting the blood supply to the skin.  The options are to limit the amount of undermining of the upper skin flap and perform liposuction of the upper abdomen (lipoabdominoplasty) or to undermine much wider and perform liposuction at a later date.  It looks like you had the second one.  Fortunately, now that you have healed, you could now have more agressive liposuction in this area with minimal risk of skin loss.  I believe these options should have been explained to you.  In your case, I would have done a combination lipoabdominoplasty and then only offered more liposuction later if you wanted even a thinner waist.  From your photos, It looks like the skin could have been pulled a bit tighter.