How often have you seen excellent results from a tummy tuck procedure, but the mons pubis is still hanging, full, and wide?
Unfortunately, the mons pubis is very frequently forgotten by plastic surgeons in Toronto and elsewhere, who concentrate solely on the abdomen and forget to look at the harmony between the various regions of the patient. We all agree that this area is very important as it paves the way to the genitals and therefore sexuality.
And yes, a less-than-attractive mons pubis can be seen in both women and men, whether or not they’ve lost a lot of weight.
The mons pubis is the hair-bearing triangular region of fatty tissue that sits just above your anterior pubic bone. It is in between the lower abdomen and vulva (or between the abdomen and the penis for men) as it progresses into the external genitalia (the labia majora for women). This hormonally sensitive region does change shape with weight fluctuations, with age, and with menopause.
The mons is a crucial area to consider with all tummy tuck procedures. It is even more crucial when undergoing a labiaplasty in order to obtain a true balance of the external female genitalia.
Most common complains with the mons pubis are the extra fullness, the loss or lack of the sexy, youthful triangular definition, the soft tissue hanging over the external genitalia, the difficulty with hygiene with overlapping skin, the self-esteem issue, and the pain and rubbing with sexual intercourse.
The most common way to address these issues is with a transverse incision and excision of excess soft tissue, tumescent liposuction to debulk the region, then liposculpting to restore the youthful triangle. With this technique, the mons pubic can also be suspended to the abdominal fascia, a thick and strong anchoring layer.
This technique is a common one that can be performed using a C-section scar or at the time of a tummy tuck or lower body lift (belt lipectomy) procedure. This technique is excellent, and the scar is concealed. However, it does slightly bring up the pubic hairline, and a few laser hair removal sessions are usually required to bring this line back to a more aesthetically pleasing level.
Occasionally, when the issue is strictly excess volume with no excess of skin, liposuction and liposculpting might be sufficient, assuming the skin elasticity is still excellent.
For the serious weight loss patient, the horizontal widening of the mons pubis might be such that a vertical correction is required in order to recreate a triangular-shaped mons pubis. Suspension to the fascia is still possible, yet the access is slightly more limited. This works well in women who keep some hair over the mons as the scar will be hidden right in the midline. It is also an option for those not interested in a horizontal incision line.
The more involved lower body lift procedure often includes an inner thigh lift. The incisions are different but will also achieve a mons pubis rejuvenation.
The smaller techniques can be performed with local anesthesia with intravenous deep sedation or general anesthesia. The tummy tuck and lower body lift procedures are always done under general anesthesia.
A compression garment is recommended for 3 weeks after the procedure, and patients can gently return to normal activity within 2 weeks.
Fat taken out when debulking the mons pubis can also be used for facial fat grafting using the Coleman’s fat transfer technique.
Monsplasty is a relatively simple addition to other body contouring surgeries that makes a big difference in a patient’s outcome. There is no reason why this unspoken procedure should be neglected anymore.