Do surgeons lift the pubic area during a panniculectomy?

Question

Because of pregnancy and extreme weight gain and loss, my skin has stretched a little in the public area (where the blurred out triangle usually is in before and after photos). Do surgeons lift that area during a panniculectomy?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question. A panniculectomy primarily focuses on removing excess skin and fat from the lower abdomen, but it does not typically include a formal pubic lift. However, depending on the extent of the surgery and how much skin is removed, there can be some natural lifting of the pubic area as the excess skin is pulled down.

If you're specifically concerned about the pubic area (sometimes referred to as the mons pubis), a more comprehensive procedure like a tummy tuck or even a mons lift can be considered. During a tummy tuck, the pubic area is often lifted and contoured as part of the overall tightening of the abdomen, providing a more balanced result.

I recommend discussing your goals with your plastic surgeon to ensure you’re getting the right procedure for the desired outcome.

Sincerely,
Dr. Katzen

Dallas Buchanan, MD · Answer

Thank you for your question. In short the answer is no. A panniculectomy is a functional operation meant to remove excess skin to prevent wound breakdown and rashes and cosmetic issues or concerns do not factor into surgical decision making. From the pulling of the closure, you may notice some indirect improvement of the mons area, but this area will not be directly addressed with a panniculectomy. If this area concerns you, then you should discuss with your surgeon other cosmetic options available to you.Hope this helps!

Richard K. Vanik, MD · Answer

Hi,
It sounds like a few things may need to happen... Typically the answer would be no. 
After the majority of your weight loss, “tummy tuck” abdominoplasty and panniculectomy can tighten loose sagging tissues. This surgery is designed toremove and re-drape redundant lower and middle abdominal wall skin and fat. An incision above the pubic region and extending towards the hips places the scar where it can be hidden by most clothing. The skin and fat are separated from the underlying fascia (layer covering the muscles of the abdominal wall). In the standard operation this dissection continues up to the ribs exposing the vertical muscles (rectus muscles). The skin around the belly button (navel or umbilicus) is divided so the redundant tissue of the upper abdomen can be pulled down. This hole will frequently be pulled far enough down to be removed with the excess tissue. When less tissue needs to be removed, this hole may become a short vertical component of the lower scar. The abdominal wall muscles are then drawn together in the midline narrowing the waistline. This stitching firms the abdominal wall and removes some bulging. If you are also having a hernia repair it will be dealt with at this time.The repair of a hernia depends on the size of the hernia. The standard method of hernia repair involves making an incision in the abdominal wall. Hernia repair done concurently with a panniculectomy may include a midline incision as well as a “bikini line” suprapubic incision. Conversely, there may be no additional incision, other than the suprapubic incision, when the hernia repair is done concurently with the panniculectomy. This area, the hernia, is then repaired with sutures. Often a prosthetic material such as mesh, another plastic or biological material is sutured in place to strengthen the area and close the defect.
The skin flap is then stretched down, the extra skin, underlying fat and tissue is removed. A new hole is cut for the navel, if you choose to transplant your navel, and contoured to create its shape. There are other options that can be discussed with your surgeon for the look of a navel without the possible complications of the transplanted navel not taking in its new location.
There may also be some degree of Mons Pubis (the mound of fatty tissue just covering the pubic bone just above the pubic area) lift after panniculectomy.
Good Luck

Alex Kim, MD · Answer

Typically, a patient who requests to have panniculectomy have a large fat deposit over mons pubis area, in addition to excess skin and fat in the central lower abdomen.  It is my practice to remove excess fat in the mons pubis area at the time of panniculectomy to make the area smooth.  This will not affect the labia or vagina, however, overall protrusion can be improved by doing this.  Ask your surgeon prior to procedure about this.  Best,Alex Kim, MD

Do surgeons lift the pubic area during a panniculectomy?

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Do surgeons lift the pubic area during a panniculectomy?

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