This is definitely a “below the belt” discussion. The mons pubis, a section of tissue that rests on top of the pubic bone, becomes a bother as it becomes enlarged with fat and accumulates sagging skin. The solution is a little-known procedure, often performed along with a tummy tuck, called monsplasty or mons pubis reduction surgery. In my San Jose practice, I see many patients who don’t realize what is causing their concerns and how it can be fixed. Read on to learn more.
Mons pubis: protruding and sagging
Those are the main complaints. A patient will express concern about excess fat over the mons, which causes the area to protrude. Women often complain that it affects the type of clothing they wear, because of a visible bulge in form-fitting garments, bathing suits, and even underwear.
It is also not the most responsive area to fat loss through diet and exercise.
- Excess fat: An enlarged mons pubis area may be due to simple weight gain, hormonal factors, and even genetic disposition.
- Weight loss: Weight loss (extreme or otherwise), may contribute as well. The loss of fat may leave loose, and sagging skin.
- Surgery: Many women who have had C-sections to deliver their children, note that following the surgery, the pubic area appears to “stick out” more. The remaining scar may accentuate the problem. The C-section scar itself remains tight to the underlying fascia, while the skin and surrounding tissue below the scar line (over the pubic bone), do not.
- Skin laxity: Elasticity of the skin is also a factor. Looser skin may be part of your genetic makeup, a byproduct of pregnancy or weight loss, or, a natural result of aging.
The good news in this discussion is that the problem is not normally a medical or health concern. That doesn’t mean it isn’t troubling—and real.
What to do?
There are a couple of approaches, including liposuction on its own, or a combination of liposuction with another surgery, (monsplasty or mons pubis reduction).
Can’t a tummy tuck just solve the problem?
Unfortunately, no. A tummy tuck (abdominoplasty), tightens the skin and muscle of the abdomen, not necessarily the superpubic region.
Very often, liposuction is performed along with a tummy tuck. If you’re having a tummy tuck with liposuction, you and your plastic surgeon will decide, prior to surgery, which areas will be liposuctioned (stomach, flanks, buttocks, etc.)
What often happens is a patient will not note the excess fat in the pubic region, until seeing the results of the tummy tuck. Often, your doctor will tell you ahead of time, that this may become a concern. (The last thing your doctor wants is for you to come back after the beautiful results of your tummy tuck, and then say: “But what’s this?”)
During your consultations, you should discuss your concerns about what lies beyond the bounds of the tummy tuck.
Liposuction alone is frequently used to remove excess fat in the mons pubis, and often will produce the patient’s desired result. As we described above, liposuction of this additional area can be performed at the same time as a tummy tuck, as well as liposuction of other areas, if the patient wishes.
Monsplasty/mons reduction surgery
This is a surgery to reduce and remove loose, hanging skin in the mons region. Depending on the individual case, there will be some scarring, either vertical, horizontal, or in some instances, both.
A mons reduction surgery can be and often is performed along with liposuction of the area.
Things to know
Some pluses and minuses: As we said, liposuction alone can often solve the problem.
But, the liposuction surgical procedure, while producing minimal scarring, may not resolve the issue. Remember, it’s fat removal, and some residual skin tightening. If your skin and tissue are loose and hanging, liposuction will not address those factors, and once the fat is removed, may even cause the loose, hanging skin to be more noticeable.
Monsplasty, or mons reduction surgery, as described above, produces more scarring than liposuction. While it is possible to perform a mons reduction at the same time as a tummy tuck and liposuction, it’s best to take your doctor’s advice on this before insisting on having it done all at once. It might be better in some cases, in terms of healing time and risk of infection, to have these procedures done in separate stages.
Dr. Vincent Lepore is a board-certified plastic surgeon in San Jose with extensive experience in body contouring surgery. Please contact us to schedule a consultation or call us at (408) 356-4241 with your questions. Cosmetic consultations are offered free of charge.