Some ladies notice that their pubic area seems more prominent after tummy tucks and this may be due to a variety of factors, which some of the other doctors have addressed. I've noted that pubic swelling was more common after liposuction of the pubis, so I've generally switched over to direct lipectomy, where the pubic flap is elevated, the fat excised directly off it and then the excess skin cut out. I tend to bring the tummy tuck drains out through the pubic area and that also helps to off load the "edema" or swelling, which tends to collect here because it's an area, which is rich with lymphatics. Lymphatics are the thin walled vessels, which are distributed with blood vessels. I frequently recommend, ugh reactionary "panty girdles", to compress the pubis, but it always resolve by 90 days, at the latest. Good luck.
Pubic swelling
Lavinia Chong, MD answers: Pubic area appears bigger after Tummy Tuck
I'm now 6 weeks post-Tummy Tuck, and I am pleased with the results. However, I'm bothered that my pubic area appears to be 2-3 centimeters higher/bigger that it was pre-operation. My underwear used to cover the area completely, but now they don't. Is this normal? Will the skin eventually stretch back to its place?
Contact the doctorA: Enlarged Mons can be liposuctioned 6 weeks after Tummy Tuck
Ariela,
The Mons Pubis can increase in size after abdominoplasty. I have noticed that when I tighten the muscle layers above the mons, this pulls the fatty tissue of the mons together and causes them to bulge. The sugery all by itself can also create swelling in this area. In most of my tummy tucks, mons reduction is a major part of the procedure. This usually involves removing the deep fat layer and liposuctioning the mons at the end of the surgery. The goal is to have a mons that is not prominent at the end of the procedure.
If you have a bulging mons 6 weeks after your tummy tuck, you may need additional liposuction to correct the fullness.
A: Time vs. Liposuction vs. Pubic Lift
With time, the problem may dissipate. If not, you may consider liposuction or a pubic lift. The appropriate procedure is determined by how much of the excess tissue is fat and how much of the excess tissue is skin. If you have not had major weight loss, it is most likely fat and this can be easily treated with liposuction. Most plastic surgeons prefer not to agressively liposuction the pubic area at the same time as a tummy tuck because this may compromise the healing of the incision. For patients that have excess fat in the pubic area prior to tummy tuck, we try to improve the look as much as we can, but it is not uncommon for this to be corrected as second procedure at a later date to be safest.
A: Some of this is worsened by swelling and will improve
Hello,
Some of this change is related to your early post-operative condition and another part is related to the choices your surgeon made at surgery in managing how things were back then. Lower incisions are nice, but can be pulled up by tighter closures.
How things sort out depends to a great extent on how your surgeon decided to deal with the "tighter versus lower" compromise and how you looked beforehand. Give it some time to sort out before you do anything about it.
Best Regards
A: Wait at least 3 month. Liposuction and/or lowering your incision
This is a combination of upward migration of the abdominoplasty scar as well as swelling from lymphatic interruption.
The main lines of treatment:
- Wait for at least 3-6 month for the swelling to come down.
- Revision of the abdominoplasty incision to a lower level. Liposuction could be helpful at this stage.
- In rare cases (mainly following massive weight loss) there is a need to perform excision of the pubic margins.
