Tummy tuck with no muscle separation? (Photo)

The reason of protruding abdomen is mainly 3 and most commonly the combination of the 3. 1)Loose muscle as the result of pregnancies, gaining and losing significant weight (expansion—deflation), or genetics and some develop real dyastasis. 2)Visceral fat which is genetical and also because of high BMI. 3)subcutaneous fat.
Recommendation number 1: have a BMI below 25. 2.-you will be candidate for Tummy Tuck to remove the excess of skin and 3)a wide and tight muscle repair to create a flatter abdomen and smaller waistline. Muscle is literally a steak and it will not remain tight forever, and your enemy number one to remain flat is to put on weight and gain visceral fat and also you must work out to get tonification of yor muscle.
Be encouraged.
Dr. Cárdenas

Hi. It is hard to give the best advice without physical examination. In some instances there is visceral fat deep to the fascia that cannot be addressed with liposuction. In some instances the fascia is lax and stretched which would still benefit form fascia plication even if distance between the Rectus muscles is not too wide. Hope this helps.

Thank you for your question and for sharing your images. It's not always easy to provide a definitive answer without a physical examination. From your photos, it appears you have minimal body fat, but your abdomen is visibly distended. The ultrasound suggests that there's no muscle separation, which leads me to believe that your condition might be due to increased visceral fat or volume in your peritoneal cavity.
This means that the area behind your rectus muscles has expanded, causing your muscles and abdomen to bulge outwards, giving your abdomen its enlarged appearance. This distention can occur even without muscle separation, like an inflating balloon stretching its material without tearing it.
In your situation, liposuction would not be beneficial as there's no significant excess fat to remove. A tummy tuck, on the other hand, would address three key areas: skin, fat, and muscle. Given that your primary issue seems to be distension of the muscle, the focus of your tummy tuck would be on muscle repair.
In your procedure, an incision would be made low on the abdomen, and tissue dissection carried up tothe sternum. After this, the rectus muscles would be plicated or sutured flat. You might need both vertical and horizontal suturing due to the degree of your abdominal distention.
Given the extent of your muscle distension, you might also benefit from the insertion of mesh to help flatten your abdomen. The final steps of the procedure would involve removing any residual loose skin, although this does not seem to be substantial in your case.
The umbilicus or belly button would also need to be repositioned due to the overall alteration of your abdominal structure. Thus, I would strongly recommend a full tummy tuck procedure, focusing on rectus muscle plication due to your distended muscles.
This recommendation, however, is based on your provided photos and description. A physical examination is needed to confirm this plan and ensure it meets your unique needs and desires.
I hope this gives you a better understanding of what could be done to address your distended abdomen. I encourage you to consult with a board-certified plastic surgeon for further advice.
Sincerely,
Dr. Katzen