Why would I need a puboplasty with TT? What IS puboplasty exactly? (Photo)

Question

I had a consult for a TT and was told my TT would end up being 3 procedures. The TT itself, a flankplasty (extended TT?), and a puboplasty. I am confused. I thought the TT would lift the pube area so how is puboplasty a separate thing? After seeing photos of mons lift (I could not find puboplasty photos) I am horrified. I need some clarity on what a puboplasty is/entails, and do I need this procedure? I don't even know whether to expect great or so-so results having these 3 procedures.

William T. Stoeckel, MD · Answer

You appear to be a good candidate for just a tummy tuck. If your consultation surgeon is suggesting that you need to pay more than the average patient for multiple procedures, you just need to visit another surgeon. A traditional abominoplasty will correct any laxity you have of the mons pubis. If you require some extension of the horizontal scars to capture more of the skin on the hips, it would be minimal and I personally would not charge more than what I would for any other tummy tuck patient. I think you are confused because your consultation surgeon is confused.

Farhad Rafizadeh, MD · Answer

It is not unusual to hear extra names of procedures that are normally included in one procedure. This is  done to justify a higher price. Some times the mons pubis requires some liposuction to debulk it. The TT has to be extended as far as needed in the flanks in order to eliminate the excess skin in that area. There is no need to call that a flank-plasty. These are all part of the TT procedure as we want to achieve the best results for the patient and not end up with extra skin hanging on the sides. We also hear facelift and neck lift as if they were two different procedure. In fact every facelift has to address the neck and the surgeon has to attempt to get the best results in the neck when he does a facelift. Having said this I have to admit that every procedure has to be individualized. Every TT is not the same, just like every facelift is not the same. I always see the patients before I quote them a price, or we give the patients a price range, if they haven't been examined in person yet. This is why you really can't shop around on the phone for plastic surgery procedures.  
You will require a TT with muscle plication to improve your bulging. You will also benefit from some liposuction in the flanks and extension of the skin resection as far to the sides as needed to avoid dog ears and not have excessive laxity on the hips. You should expect excellent results.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Depending on how much sagging, if any, of the mons region, it occasionally needs to be lifted in addition to the tightening of the abdomen, as a tummy tuck will not always correct this.  Best to seek out a series of consultations to get the best advice.

Kenneth Hughes, MD · Answer

The tummy tuck by itself does not resolve a bulky mons area. Additional Liposuction of this area is necessary to debulk the area.

John L. Burns Jr., MD · Answer

For optimal aesthetic results, addressing the mons area with a tummy tuck is critical to avoid a flat abdomen adjacent to overprojecting mons.  This can require an vertical incision to remove some excess tissue in the area.  Also, for optimal results, extending the incision to include the flank skin and fat will result in a better overall contour:  extended tummy tuck.

Ramiro Morales, Jr., MD · Answer

Thank you for your questions an pictures.  As part of the tummy tuck procedure, any well trained PS will be also raising and if necessary liposuctioning the prepubic area, or mons, to give it a good, aesthetic and proportional contour.  Be sure to see a Board Certified PS for your consultation.

Daniel Barrett, MD · Answer

Dear dcj5295,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

I would suggest discussing this with the surgeon you saw. Many of us combine work on the pubic area with the tummy tuck. Some charge separately for this.  Sounds like your surgeon charges separately for this.

Camille Cash, MD · Answer

From your photos it appears you are a good candidate for a standard tummy tuck.  Often patients will elect to have some liposuction done at the same time of the flank area to enhance curves.  If the mons area is a concern, it can be addressed as well.  An exam would be needed to know for sure, but it doesn't appear that would be an issue in your case.  I encourage you to visit with a few board certified plastic surgeons near you for consultations.  It is important that you feel comfortable and confident in your surgeon and surgical plan.

Richard Mark Winters, MD · Answer

You havre a long torso, a narrow waist and are not obese... this makes you a great candidate for a tummy tuck.... in my tummy tuck practice, the operation routinely involves repair of any diastasis (separation of muscles in the midline), lengthening of the obliques to restore the waist (perhaps what’s being called ‘flankplasty’), liposuction of the flanks (again, ‘flankplasty’) when appropriate and always surgical removal of the fat pad above the pubic bone.... many surgeons perform liposuction for this, but I prefer direct excision as it is more meticulous and anatomically correct.... I don’t care for the term ‘monsplasty,’ but in my view that is more appropriate for the massive weight loss patient whose extra skin and fat obscure their genitals

When there is an extraordinary amount of excess skin around the flanks and back, we can perform extended incisions to accommodate this (often all the way around the patient), but in cases like yours there is usually no need to extend the incisions

Good luck...

When there is an extraordinary amount of excess skin around the flanks and back, we can perform extended incisions to accommodate this (often all the way around the patient), but in cases like yours there is usually no need to extend the incisions

Good luck...

Why would I need a puboplasty with TT? What IS puboplasty exactly? (Photo)

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