Correction of pubic flaccidity with monoplasty in the patient with extreme weight loss

An area of ​​sagging skin in the abdominal region that is not frequently addressed is in the pubic or mound area. Although a tummy tuck or body lift removes a lot of loose abdominal skin, it can still leave excess pubic skin and lead to excessive sagging. This is often disturbing to patients, as they did not anticipate this residual problem. In some, this sagging pubic skin is significant enough to interfere with intimacy or urinary flow in some patients. However, it is primarily a cosmetic issue with a sagging pubic mound that does not match the horizontal abdominal scar from your abdominal contouring surgery.

A pubic lift (monsplasty) can be incorporated as part of a body lift or tummy tuck. I use a lower central abdominal incision location when performing a body lift or tummy tuck so that the sagging pubic area (if present) is lifted higher than the surrounding areas. This is a simple modification of the frontal abdominal excision that can avoid the need or desire for a secondary pubic procedure. It’s like dropping a shallow “U” -shaped extension from your planned lower abdominal incision. However, one of the cosmetic “problems” this modification will create is that the buffer zone between the final incision / scar and the pubic hairline is lost. The pubic hairline will be brought up to the scar line. This can be easily remedied later with laser hair removal.

If there is an area of ​​flaccid muscles after an abdominal procedure, it can be lifted with a much minor operation later on. An inverted U-shaped cut pattern is made starting at the existing lower abdominal incision. The extra loose skin is removed so that the flabby part of the pubic area reaches the scar. The same problem will also result when connecting the upper part of the pubic hairline with the posterior horizontal abdomen.