CT scan Shows D.R. at belly button and slightly above but none below belly button. Would a TT still be ideal? (Photo)

A CT scan does not necessarily show the full extension of the rectus diastasis since you are on your back during the test. The diagnosis is dynamic which means that you need to be examined with muscles relaxed and contracted. In your picture, the muscles are contracted so the diastasis is reduced. But once you relax, that's where you see the extent of it. After any pregnancy, there is some degree of rectus diastasis but some camouflage it with consciously keeping their muscle contracted and some who don't. It depends all on how it bothers you so you can get a tummy tuck.

I tend to rely on physical exam findings and functional concerns to determine the main benefits for DR repair.
Normally you can feel the separation by doing a partial sit up. And if you see a lot of fullness standing up but not when laying down that can be a sign as well.
If you have any issues with lower back pain, urinary incontinence or other "core" weakness related symptoms then DR repair might be able to help those.
A full tummy tuck tends to be much more dramatic in terms to skin removal, final tightness and if you're going to do all of that might as well tighten the muscles as much as appropriate to get those benefits as well.

Thank you for your inquiry and adding photos as well! An abdominoplasty would be beneficial as that includes muscle repair of the diastasis recti and liposuction of the abdomen. Without muscle repair, surgery would only remove excess skin making the diastasis recti more noticeable. Muscle repair would allow your abdomen to be as flat as it is when you suck in. I recommend scheduling a consult with a board certified plastic surgeon like myself so we can create a surgical plan based on your goals.

Dear brittanys09,
based on your photo, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

A full tummy tuck would be recommended if any issues exist above the belly button, therefore for you it would still be recommended.

A full tummy tuck would definitely address the problem. A mini-tummy tuck would not address the problem and may still be noticeable. It is a risk/benefit issue for you. You may be satisfied without a full TT, but won't really know until a good exam is done. Hard to evaluate with just pictures. Hope this helps.

Thank you for providing a photo. You would benefit from a full abdominoplasty. With that, you will get a full DR repair from top to bottom. After 4 pregnancies, you will have a separation in the muscle that would benefit from repair.

It’s hard to tell in the photo how much loose skin you have. The amount of excess skin is more of a factor than diastasis

Your photo is limited. I would suggest reposting with a unobstructed full view of your abdomen with arms at your sides and front and side views. You could also do nonsurgical EMSculpt to tighten and correct the diastasis.

If you are wanting the optimal result it's recommended to have muscle tightening during your tummy tuck. It seems logical to have it addressed since your surgeon is there regardless. It may make your recovery a little longer, but most would argue that it is worth it.