One area of loose skin in the abdominal region that is not frequently treated is in the pubic or mons pubic area. Although a tummy tuck or body lift removes a lot of loose abdominal skin, it can still leave excess pubic skin behind and lead to a droop of the mount of Venus. This is often upsetting to patients, as they did not anticipate this residual problem. In some, this loose pubic skin is significant enough to interfere with intimacy or urinary flow in some patients. Mostly though, it’s just a cosmetic issue with a mismatched drooping pubic mound below the horizontal abdominal scar from her abdominal contouring surgery.
A pubic lift (monsplasty) can be incorporated as part of a body lift or a tummy tuck. I use a more inferior lower central abdominal incision location when performing a body lift or tummy tuck so that the sagging pubic area (if present) is lifted more than the surrounding areas. This is a simple modification to the frontal abdominal excision that can avoid the need or desire for a secondary pubic procedure. It is like dropping a shallow “U” shaped extension of the planned lower abdominal incision. However, one of the cosmetic “problems” this modification will create is that you lose the buffer zone between the final incision/scar and the pubic hairline. The pubic hairline will be brought up to the scar line. This can easily be remedied later by laser hair removal.
If there is a sagging mons area after an abdominal procedure, it can be lifted with a fairly minor operation later on. An inverted U-shaped cut pattern is made from the existing lower abdominal incision. Additional loose skin is removed so that the flaccid part of the pubic area is closer to the scar. The same problem will also occur with the connection of the upper part of the pubic hair line to the posterior horizontal abdomen.
