Still Debating on

I have been debating on a tummy tuck since 2009. At one point I was so ready and a Friday before the surgery I called the Surgeon's office and canceled. Luckily he refunded all the money but $500 for blood tests. Now two years later I want to do it again. I went from 115 to 222 pounds after I had my second child. They are now 8. I had them 10 months apart. After that I had 3 miscarriages. I finally learned I would not be able to have more children. I am now at a steady 145 pounds and 5ft-2in short. I had a personal trainer told me he didnt want to take my money because no matter how hard I tried, that excess skin will always be there. I have such great fear of being put under anesthesia. Death always comes to my mind. I think of my 2 girls and how they would suffer without me. But I am at the point where I also get frustrated when it comes time for a special event. I hate how my clothes fit me or actually the clothes I want to wear don't fit me. Even my girls tell me I could wear a bathing suit only if I fix my stomach. One even said I look like a peanut. My skin is as rough as one and the shape of my stomach. I want to do the surgery next month. I have met with 6 doctors and have 2 in mind but fear is stopping me. I have read many of the stories in order to give me motivation but something in the back of my head still tells me not to. I know I need it. I have posted some pictures so I can get some feedback. Also, I noticed all surgeons advised me to get lipo on my flanks. Is that really necessary? Does it make a huge difference?