Can a muscle repair ever cause more harm than good? (Photo)

Hi there,
Certainly muscle repair can cause issues if done incorrectly over fixed overly tight. The sutures we use to repair the muscle could also become infected, however this is very rare. This usually goes off without any complications and helps return the muscle to their natural position, increasing the wall strength, and making the lower abdomen flatter.
You appear very thin from the photos you sent so lipo, in my opinion, will likely have a minimal effect in giving you an hour glass shape as there is very little fat to remove
What you may want to consider is getting a full tummy tuck. This will remove the excess loose skin from your abdomen, create a new smaller more aesthetic belly button, and possible repair an umbiilcal hernia if present (possible based on the photo but you would need a physical exam or imaging to be sure).
Mini tummy tuck is always an option was well but would depend on the MD you go to, as we all do it a little differently
All the best

From your side view, you can see your abdominal wall protrudes slightly forward. If you want the most hourglass shape, I recommend the fascial repair. The muscle is not repaired but the fascia, which is the envelope containing the muscle, is tightened. You would not benefit from liposuction as you appear much too thin for that.

Best Wishes,

Gary Horndeski, M.D.

Patients benefit from having the abdominal wall addressed as it can improve the contour long term. The drawback is there is a bit more recovery from it. From the submitted photos it does appear that you would benefit from the tightening, which is common after pregnancy or weight gain/loss. Liposuction of the flanks is used to contour the torso. It is not needed in every patient but is a common request.