I am a post bariatric surgury patient. In August of 2008, I had Rouxen-Y Gastric Bypass. I have reached my goal weight with the loss of 150+ pounds. My abdominoplasty/Panniculectomy procedure is scheduled for November 2, 2011. My major concern is that above my pubic bone, the skin is saggy from weightloss as well. Will the removal of excess skin and fat smooth this area out? I am unable to have the complete lower body lift as the procedure is covered under my medical insurance.
Will Abdominoplasty/panniculectomy Eliminate the Fullness at the Pubic Mound After Massive Weight Loss?
Doctor Answers (15)
Abdominoplasty for pubic fullness and laxity
After very significant weight loss it is typical for lax skin and fullness into the mons pubis and this can be a very troublesome for many. The tummy tuck, or body lift, pattern can be tailored to contour and reduce the pubic mound. Panniculectomy under your insurance may not include this correction, or the upper abdomen as in full tummy tuck for some. The rule is never assume and ask your surgeon specifically what will be done during your procedure.
Best of luck,
The mons pubis can be addressed at the same time
Yes, the mons pubis can be lifted and reduced at the same time as your tummy tuck. It can be corrected in several ways but a combination of incision placement, liposuction, and direct excision will offer the best results. If your procedure is covered by insurance your plastic surgeon can simply include your mons pubis lift as part of the incision placement of you panniculectomy.
All the best,
Tummy tuck for pubic mound
Almost all women need a mons pubis correction during abdominoplasty whether or not they have lost weight. I always reduce or lift the mons as part of my full abdominoplasty. Make sure you discuss this with your surgeon before your procedure.
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Need liposuction of pubic area
Fullness of the pubic area is very common. Sometimes surgeons perform tummy tucks without treating this area and patients are unhappy because they have a bulge. It may even be accentuated because the tummy is flatter.
So I commonly treat this area with liposuction the same time I do a tummy tuck or lower body lift. It there is an insurance issue, you may need to have this done at a future date.
Monsplasty May Still Be Needed After Abdominal Panniculectomy
A monsplasty, or pubic reduction, is often needed secondarily after large abdominal panniculectomies or extended abdominal contouring procedures in the bariatric surgery patient. This often can not be made as flat as the abdomen above the incision line when addressed at the same time as the abdominal contouring procedure. It is more successfully managed at the time of the abdominal procedure in the weight loss patient than it is in the heavier panniculectomy patient. But a persistent pubic sag can still exist afterwards despite the plastic surgeon's best effort. Either through liposuction or a combined pubic lift and liposuction, it can be significantly improved later. This will not be an insurance covered procedure if needed secondarily.
Tummy Tuck - Will Abdominoplasty/panniculectomy Eliminate the Fullness at the Pubic Mound After Massive Weight Loss?
The mons pubis (pubic mound) often requires specific attention as part of a tummy tuck, whether being done in a post-bariatric situation or not.
Sometimes a bit of liposuction is all that is needed to contour that region (sometimes no specific procedures are required at all) but at other times excess tissue needs to be removed surgically. This may or may not be done at the time of the tummy tuck (these are things that, of course, you need to discuss with your own plastic surgeon). Most often it can be done at the same time and, in fact, should for maximum effect. These include lifting and tightening the skin, undermining (separating the deeper tissues) to allow easier movement, and debulking, whether with lipo or surgically. Certainly, leaving a heavy, sagging region (nothing personal, of course) at the mons while doing the rest of the surgery doesn't make the most sense.
Ultimately, this should be part of the preoperative planning your surgeon does, and you need to be open and upfront about your specific concerns. Addressing this area is completely appropriate and should, ideally, be done at the time of the tummy tuck.
I hope that this helps, and good luck,
Mons pubis contouring
The pubic area will not be altered by the traditional abdominoplasty, but if you discuss this with your Plastic Surgeon he or she should be able to elevate the loose skin and contour this area with the tummy tuck. On occasion limited liposuctioning may also need to be performed. Lower body lifts in which the medial thighs and abdomen are to be contoured will often correct this area satisfactorally.
Definitely bring it up
This issue is often not raised by patients as it sometimes isn't "seen" prior to removing an apron of skin. Some of these patients return with flat abdomens but unsightly bulges "down below." A quick conversation with your surgeon will avoid a lot of grief down the road.
Bariatric weight loss
The Mons region is not addressed by standard abdominoplasty. I f you want the pubic area addressed you should discuss it with your surgeon.
Lifting the Pubic Mound
There are specific maneuvers a surgeon can perform to lift a sagging or full pubic mound during body contouring surgery after massive weight loss. These techniques can involve liposuction to the area during the time of the abdominoplasty and possible suturing the mound higher to restore its natural position. Remember to express your concerns with your plastic surgeon during your consultation before surgery so that you can ensure they are addressed.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.