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.

     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

You will be beautifully benefited with a nice and tight muscle repair in order to get a flatter abdomen and tapered waist. The TT will only help to get rid of the saggy skin, but not much improvement on the waist and protruding abdomen.You will be loving your results.Have a great journey.Dr. Cardenas

A tummy tuck is really not a tummy tuck with out the rectus muscle repair.  You can tighten your skin all you want, but if your muscles are still spread apart (like yours are) your abdomen will not be flat for long.  Make sure you are done having children and do the right thing - TT WITH muscle repair.

I  assume you are asking if you should have a full or mini tummy tuck.  Based on the photo provided you will have a best result with full tummy tuck.The mini tummy tuck operation is an operation
that addresses the lower abdominal wall, below the umbilicus. The “full” tummy
tuck operation involves treatment of the entire abdominal wall; this operation
serves to remove excess skin, re approximate the abdominal wall muscles that
may have spread with pregnancy and/or weight gain/loss, improve the appearance
of the waistline and often pubic area as well