As you have now discovered, pregnancy
causes stretching of the abdominal wall and overlying skin and soft tissue. This causes a loose and saggy appearance of the abdominal skin and tissues, and a "poochy" appearance of the lower abdomen. You are doing the right thing in working on your fitness, but unfortunately, even significant muscle building and weight loss may not reduce the appearance of loose abdominal tissue.
Tummy tuck surgery, or abdominoplasty, is often the appropriate solution. Some women may be candidates for the "mini tummy tuck
" procedure, which removes c-section scars and the loose tissue below the belly button, tightens the abdominal wall muscles below the belly button, and redrapes the tissue to create a tighter, more tight and flat appearing lower abdomen. If there is significant looseness of the abdominal tissues and abdominal muscles above the belly button as well, as is most often the case with pregnancy, the standard tummy tuck procedure would be the best solution. This procedure tightens the entire abdominal wall and removes a much greater amount of loose, redundant tissue and skin, which creates a tight, flat appearance of the entire abdomen. Typically, it is wise to wait at least 6 month after childbirth before having a tummy tuck, but surgeons vary on this.
Your board certified plastic surgeon will be able to answer which would be the best procedure for you.
All the best,