Do I require muscle repair? (photos)

Hi Victoria,
You may be a candidate for a Tummy Tuck if your muscles are loose and contributing to the appearance of a bulging abdomen. It is hard to say without a consultation. That being said, from the photos you provided, you may benefit from a staged procedure that includes a Tummy Tuck with muscle plication to tighten your abdominal muscles (leading to the appearance of a flatter stomach) and remove your excess skin followed by liposuction to your abdomen 6 months to 12 month later. A virtual or in person consultation with a Tummy Tuck specialist will help you get an accurate recommendation and pricing.
Respectfully,Brandon Richland, MD

Your abdomen is protruding because you have a significant amount of visceral fat and because your muscle becoming very loose.
So just tightening the skin will not make your abdomen flat and either will create smaller waist.
You must lose weight in order to flatten your abdomen by reducing visceral fat and then after losing weight (BMI closer to 25) you will be candidate for an extended Tummy tuck to prevent dog ears and a tight and wide muscle repair to create a flat abdomen and smaller waist.
Be encouraged!!
Dr. Cárdenas