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?
Pubic Area Appears Bigger After Tummy Tuck
Doctor Answers 122
Mons movement after tummy tuck
With a conventional tummy tuck, considerable skin and fat is removed. The upper and lower skin areas (flaps) are then pulled together. This causes tightening in the upper flap, a desired effect, but can also elevate the mons area. The more radical the tummy tuck, the greater this effect may be. Most patients consider some mons elevation a plus, since the mons tends to "sag" after pregnancies.
Shortly after surgery, there is swelling and firmness due to healing and swelling from the liposuction that is often performed at the same time as the tummy tuck. Of course patients should make sure with their doctors that this swelling does not represent a collection of fluid, but that is easy to determine at your doctor's office during a postoperative check.
Patients are often under the impression that making an extra low incision will leave the final incision lower, and therefore more concealed by a bikini-type garment.
This can be false.
The lower the incision, the more skin and fat must be removed, since the upper incision is above the belly button. In many patients, especially patients with high belly buttons or thinner patients who have less excess skin and fat to be removed, this can cause excessive tightness.
Excessive tightness leads to poor scarring and weird elevation and elongation of the pubic structures, an uncorrectable and disturbing problem. Excessive tension on the incision also predisposes to poor wound healing and greatly increases the chance of the skin pulling apart, necessitating weeks or months of dressing changes.
So every patient is different. A skilled plastic surgeon can draw where the anticipated incisions will be during surgery, and estimate where your final incision will be.
It is not realistic for every patient to have a "bikini incision" after a full tummy tuck.
Swelling of the (mons) pubic area after tummy tuck
This is very common and seen in nearly all patients.
If you are very active during the day it can become worse. This is due to the fact that it is the lowest part of your surgery and all the swelling settles there.
However, the other physicians comments about a full pubis are also true and if this persists after several months you may want to consider liposuction or surgical reduction known as a monsplasty which may be able to adjust the height of the incision.
I want to clarify one point which seems to be ignored. It is clear that the benefits of a low incisions are desireable from a cosmetic standpoint. However there are limitiations due to the umbilicus and not everybody can have a low incision without an additional scar.
- If the scar is put too low than the hole where the belly button was will not be able to be excised and this will leave the patient with a potentially visible vertical scar between the new belly button and the horizontal scar.
- When I discuss this option with patients they prefer a slightly higher pubic scar to avoid the vertical lower abdominal scar.
Hope this helps!
Addressing the pubic area during abdominoplasty - tummy tuck
The pubic mound undergoes specific changes with age, pregnancy, and weight gain. This causes the pubic mound to protrude or sag. In some cases, the amount of pubic redundancy is not noticed by a patient in comparison to the abdominal bulge or excessive overhanging skin.
When considering an abdominoplasty procedure, the specific procedures to address the pubic mound should be discussed. This will allow the surgeon to address this critical area during the abdominoplasty procedure. It should be noted that the main components of an abdominoplasty do not address the pubic mound specifically.
Thus, if you are concerned about this area, make sure to discuss treatment options including fat resection, alteration of incisional pattern, and liposuction prior to surgery.
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You'll probably need to have this area revised
When I perform a tummy tuck, I usually remove some of the excess fat and excess skin from the pubic region. This helps to raise and flatten the pubic area and give a more youthful look. The scar should be hidden within your panty line.Ask your physician about revising the pubis. That should do the trick.
The lower the better
A little pre op planning goes a long way. In general, the lower the scar is positioned the better the result. Remember that when the incisions are mapped out before surgery, the final scar will come to lie somewhere between the upper and lower incision. There are a few things your surgeon can do to keep the incision low. Many surgeons now utilize progressive tension suturing which will take tension off of the closure and help to keep the scar below the top of even a small bikini.
Overly Lifted Pubic Area with Tummy Tuck
Regarding: "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?"
I regret your predicament. Unfortunately, your surgical planning is at fault. Experienced Tummy Tuck surgeons assign a priority to how they want to treat the Mons pubis. In most women, it benefits from a mild BUT CONTROLLED lifting to a youthful position but under no circumstances must it be hiked to rise way above the rim of the underwear. For this reason, you should have been marked IN your underwear with the skin under stretch to simulate a lift of the area and the Mons. An overly long Mons is shortened by placement of a low incision. Moreover, the vector of lifting should NOT be central,limited to pulling the mons up but lateral, directing the pull to the thighs.
Although there will be some sagging of the mons to its lower position, this may take years to come about.
Dr. Peter Aldea
Swollen Pubic Region After Abdominoplasty Normal
It is completely normal for the mons and pubic region to appear swollen aftre surgery and appear higher as well. It may take 3-6 months for this to return toasome what more normal appearance. Alot of the edema from the abdomen gets trapped in the mons region, and the area does get pulled up during the surgery as well. As the swelling goes down and the tissues relax a little, that should improve. I hope this helps.
Pubic area is "lifted" with a tummy tuck
The pubic area is typically "lifted" with a tummy tuck -- this is a result that most women like and appreciate, but can be a surprise if you're not expecting it. The area can look "larger" as well because typically the stomach area is tightened and the pubic ares is not and therefore sometimes that area can look "fatter" than before. It is not actually fatter, it is just now located next to an abdomen that is tight and flat and therefore it looks thicker.
This will "soften" with time a little. Sometimes patients will request some liposuction to that area after tummy tuck. I usually perform that at the same time as the initial procedure if I think that it is going to look "too big". This is a decision for you and your surgeon to discuss in more detail.
Reasons for 'bigger pubic area' after tummy tuck
The pubic area may 'become larger' after tummy tuck for a variety of reasons.
If you notice that it is 'higher', it may be due to elevation of the mons area. The mons area becomes elevated in most tummy tucks to some degree. If you had a sagging mons area, the lifting can produce a significant difference in the appearance which may be a 'normal appearance'. If you did not have a sagging mons area, the tummy tuck can lift it higher than desired. This can be controlled by making the initial tummy tuck markings lower down on the mons area. Over time, the incision tends to drift downwards to some degree; you are 6 weeks post surgery and it will be many months before this settling is complete.
If you notice that the area is 'fuller', it may be due to post operative swelling or residual fat in the mons. In the first few months, it is not unusual for the mons to be fuller due to swelling; fluid tends to collect in the lowest part of your abdomen because of the effects of gravity. This corresponds to the lower abdomen and mons area. Give it some time and the swelling will improve. If you had a fatty mons area prior to surgery, the mons has been lifted, and the tummy tuck has given you a flat tummy; the fatty mons might be more noticeable now. This can be corrected with some liposuction at the time of the surgery, or afterwards.
At this point in your recovery, you may have normal post op changes I recommend you discuss this issue with your surgeon, and wait for the things to settle.
Lawrence Tong MD FACS FRCSC
The mons pubis region may be easily revised following a tummy tuck procedure
Thank you for your question. The mons pubis region may be easily revised following a tummy tuck procedure. Even though you are at 6 weeks from your initial surgery, I would wait another 6 weeks to ensure your full recovery and to allow the operated areas to settle down. Revision surgery will target two tissue layers -the degree of excess fat and skin. This is usually a simple procedure with minimal risks. Liposuction alone or in combination with the surgical excision of additional skin may be required. I would advise you to return to your plastic surgeon to thoroughly discuss your concerns and to establish a treatment plan.