What’s With all the Extra Skin and Flab? Would I need a fleur de lis to improve these results? (Photos)

I’m 40 years old and I’ve had 3 c-sections. I had an extended tummy tuck with a no-mesh hernia repair and muscle repair 6 months ago (I didn’t get lipo at the time of the procedure). While my stomach looks much better than before, I thought I’d be flatter and that my skin wouldn’t look so wrinkled. The doctor said I would’ve had to get a vertical cut to get rid of the extra skin. By my before and after photos, do these results look optimal? Would I have indeed needed a fleur de lis? I feel like there’s still so much extra skin. But the doctor said they pulled my skin down and outward to get rid of as much as possible. And when I asked about the extra fat/flab remaining, the doctor said lipo would help with that. But with the removal of extra fat, would that make the skin look even looser? Did I get a “conservative” tummy tuck?