Can a Doctor Perform a Panniculectomy but Also Tighten Muscles?

Hi there-
I think you are thinking too much about this, and starting to fall into a trap I see too often- where a patient doesn't like what a surgeon told them, so they start looking for a surgeon who will tell them what they want to hear...
Nothing good will come of this...
It sound like you need a tummy tuck. There are many variations (I personally do 4 different types of tummy tucks), but the operation best for you will depend on many variables and a consultation would be necessary to make recommendations.
Your best bet is to find a surgeon certified by The American Board of Plastic Surgery that you like and trust and follow their recommendations.
If you wave a bit of money in the air, you will find someone to do what you want- but it's your body and safety we're talking about!
Here's some advice on how to find a surgeon you like and can trust:

Without photos and an examination, it is difficult to provide specific recommendations.
A panniculectomy primarily removes excess skin, especially in the lower abdomen, but it doesn't address muscle separation or upper abdominal skin laxity. If you're only concerned about the skin below the belly button and don’t have excess skin above it, a panniculectomy might be sufficient.
On the other hand, a full tummy tuck (abdominoplasty) removes skin, tightens muscle separation (diastasis recti), and repositions the belly button, making it ideal for patients seeking a flatter, more contoured stomach after pregnancy or weight loss. The tummy tuck addresses both upper and lower abdominal excess, and is often combined with flank liposuction as well to improve contouring.
It is important to consult with an experienced plastic surgeon who can customize your surgical plan and determine the best technique for you based on your individual anatomy and goals.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, and Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Hello,
Thank you for your question. Whether tightening of the upper abdominal muscles with a panniculectomy is technically possible (yes) and whether it is the best option for you are questions with two different answers. 
Without a physical examination or speaking with your surgeons, I cannot know their reasoning for recommending the panniculectomy vs tummy tuck. I do know it is human nature for surgeons tend to recommend the procedures they are most comfortable performing.
The majority of mothers I treat for excess skin and diastasis recti benefit from a tummy tuck (aka abdominoplasty) rather than panniculectomy. This approach allows for full tightening of the abdominal muscles, removal of excess tissue, and repositioning of the belly button. This allows for optimal contouring over panniculectomy alone.
Best wishes,
Dr. Moein 

Generally speaking if the panniculectomy is being performed instead of a tummy tuck, it is for safety reasons.  Under these circumstances it is usually best to stay in the lower abdomen.

Pregnancy can result in dramatic changes in a woman’s
body. These changes are especially noticeable in the abdomen, where redundant
saggy skin, weakened muscles, and stretch marks may occur. A large variety of
surgical options are available for treating these problems. The procedure
chosen for any particular patient is dependent upon their anatomic findings and
aesthetic goals.

It’s important to realize that each patient’s situation
is unique. The best results are obtained when correct analysis is performed and
the best surgical option is applied. In most cases, patients will require a
full abdominoplasty.

In your case, it’s virtually impossible to make a
recommendation without pictures or a physical examination. It’s definitely
possible to remove lower abdominal skin and tighten abdominal muscles without
detaching the umbilicus. Whether or not this approach is appropriate for you is
dependent upon a proper evaluation.

Under these circumstances, consultation with a
board-certified plastic surgeon who has experience in this area is appropriate.
This surgeon should be able to formulate a treatment plan that addresses your
concerns. 

A panniculectomy will only remove the excess skin and fat that is forming the apron of skin, and won't do anything for anything above this.  A tummy tuck with panniculectomy is probably what would better achieve your goals.

Panniculectomy and limited undermining with full rectus abdomins muscle repair is possible but unusual and would most commonly requires surgery around the umbilicus to access the upper abdomen. This can be performed endoscopically as well.

The best result would be achieved with a full abdominoplasty (tummy tuck) with rectus plication (tightening up the muscles). Without pictures or examening you, it is hard to give you specific advice. However, with panniculectomy only, the muscles can not be tighted adequately. I hope this is helpful.

Hi! Thank you for your question. Without a formal evaluation or at least pictures its hard to know for sure what you need. However, it looks to me that you will need a full tummy tuck. A Panniculectomy will remove skin only from the lower abdomen and sometimes your health insurance will cover it. A tummy tuck is a cosmetic procedure that will address not only diastasis recti or separation of the abdominal  muscles, but it will also get rid of excess skin.  I hope this helps and good luck!

Tummy tuck is mainly to improve shape and contour by plicating your core tight then re-draping the skin. Without the core tightening (muscle repair), its not a tummy tuck, but a panniculectomy (skin and fat resection). Pregnancy almost always requires tightening of your core. See a board certified plastic surgeon.