Second breast lift and tummy tuck - options? (photos)

Thank you for your question and pictures. It looks as though you would benefit from a TT for skin removal. As for the muscle repair, an in person consultation may answer this question or it may be clarified at the time of surgery. Some patients despite a few pregnancies manage to maintain normal rectus muscle (six pack) anatomy and don't require muscle plication.
As for the breasts, your breasts a not too saggy per se at this point but you have developed upper pole looseness, not unexpectedly, mostly in part due to the stretch marks and inelasticity of the upper pole breast skin. Another breast lift will tighten the skin but ultimately it will settle some again. Adding a small implant to add some upper pole fullness would certainly help, But since you do not want implants you might consider seeing a Board Certified PS that has extensive experience in breast fat grafting as another possible as good alternative.

Based on your description and the photo you provided, it sounds like a breast lift could potentially improve the appearance of your breasts and make them more firm. A breast lift, or mastopexy, is a surgical procedure that removes excess skin and tightens the surrounding tissue to reshape and lift the breasts. This can help to restore a more youthful and firm appearance to the breasts.

It's important to have a consultation with a board-certified plastic surgeon who can evaluate your breasts and determine whether a breast lift is the right procedure for you. During your consultation, your surgeon will also be able to discuss the potential risks and benefits of the procedure, as well as the recovery process and any possible complications.

Regarding the tummy tuck, it's possible that you may not need muscle repair depending on the degree of muscle separation you have. However, it's important to have a consultation with a qualified plastic surgeon who can evaluate your abdominal muscles and determine the appropriate treatment plan for you.

Overall, it's important to do your research and choose a board-certified plastic surgeon who has experience performing the procedures you're interested in. This will help to ensure that you achieve the best possible results with a reduced risk of complications.

Best of luck !