Will a tummy tuck be enough or do I have to have a muscle repair as well?

This is a hard question to answer based on pictures alone but most people who have had children benefit from muscle tightening to restore a flat contour to the abdomen.  This is part of a standard tummy tuck done all at the same time as removing the excess skin.  Anyone with a low placed belly button is not a good candidate for a mini tummy tuck as the belly button would be too close to the mons to look normal.  I woul recommend a consult with a board certified plastic surgeon to review your anatomy and help make the best operative plan.

Thank you for the question and pictures.  Physical examination should allow for an accurate assessment of abdominal wall muscle laxity and the potential benefits of muscle plication.  Having said that, b willased on your photograph, you appear to be an excellent candidate for tummy tuck surgery, including the muscle plication component.
Generally speaking, the tummy tuck procedure typically involves plication of the abdominal wall muscle that have spread during pregnancy or weight gain/loss.  It is the very rare patient who after pregnancies and/or weight gain/loss does not benefit from some degree of abdominal wall muscle re approximation.
 IN MY OPINION, omitting this part of the procedure for the vast majority of patients who present for consultation will possibly or likely leave them with continued abdominal wall laxity and, in my opinion, a less than optimal result. Make your decisions carefully…
Best wishes.  

     A tummy tuck can remove loose skin and tighten the abdominal wall at the same time, which would be the right thing for you.Find a board certified plastic surgeon who performs hundreds of tummy tuck procedures each year. Then look at the
plastic surgeon's
website before and after photo galleries to get a sense of who can
deliver the results. Kenneth Hughes, MD Los Angeles, CA