Although a formal physical exam is required to make any recommendations, based on your photos alone, it is very likely you would be a great candidate for a tummy tuck.
In this procedure, your C-section scar would be removed/revised. In addition, given your history of 4 large babies, you likely have significant muscle separation that warrants a muscle tightening/plication.
In addition, you may benefit from some adjunctive lipo of your waist to facilitate the hour glass shape.
Please visit with a board certified PS to learn more about your options. (C. Bob Basu, MD, FACS, Houston Plastic Surgeon)
Ultimately you need a full examination by a plastic surgeon to ensure that what you are seeing/feeling is a separation of the muscles and not a hernia because they are treated very differently.
If you simply have the usual post-pregnancy muscle separation a tummy tuck with muscle plication would be an excellent option. The advantage of the muscle plication is that it acts like an internal corset to flatten the abdominal wall and also narrows the waistline.
You plastic surgeon may also offer you some liposuction of the flanks and/or thighs at the same time to help balance out your shape and make you more proportional because you seem to have a nice skinny waist!
Make sure you are on a good diet/exercise plan because this will only help optimize your results after surgery and maintain a youthful body! (Megan Jack, MD, Boca Raton Plastic Surgeon)
You may be an excellent candidate for tummy tuck surgery at some point. It would be in your best interest to achieve a long-term stable weight, if you are not there already, prior to proceeding.
Generally speaking, the “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight. (Tom J. Pousti, MD, FACS, San Diego Plastic Surgeon)
Tightening the abdominal muscles would be part of your procedure. I suspect there is sufficient skin to reach down to the c-section scar. (Jourdan Gottlieb, MD, Seattle Plastic Surgeon)
A full tummy tuck with muscle repair will provide the best result for your abdominal appearance. You appear to have enough loose skin to allow removal of all of the skin below your belly button including your C-section scar. Muscle repair is definitely needed after four pregnancies. The amount of fat inside your abdomen (intra-abdominal fat) will determine in part how flat your abdomen can become after the tummy tuck. (Remus Repta, MD, Scottsdale Plastic Surgeon)
You look like a reasonable candidate for a full tummy tuck with muscle repair. The excess skin appears to allow for a single scar but that is for your surgeon to determine. Also to be an even better candidate, I’d suggest 10-15 pounds of weight loss preop. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)