Your Questions

Q: Dr. Eppley, I have had weight loss surgery and now need plastic surgery to reduce my mons pubis area. It is very large and sagging. It is uncomfortable and is creating self esteem and intimacy issues.

A: The reduction of a large mons pubis can be done by two techniques, either liposuction or a pubic lift. In some cases, both methods need to be done together.  Since you have had weight loss surgery, there is undoubtably a significant skin component to your mons as you have described it as sagging. This will require a significant lifting procedure which is essentially a reverse or inverted mini-tummy tuck. The skin resection is taken out from below and the mons is lifted up. This is in contrast to a traditional mini-tummy tuck where the skin is removed from the lower abdominal region and the remaining skin is moved downward or tucked. Whether the mons will also require liposuction depends on an examination. But my experience, even in the weight loss surgery patient, almost always needs to thin out the mons as well by fat removal. The other pertinent question is if you have a sagging mons from weight loss surgery do you have loose overhanging abdominal skin as well. This may also necessitate some form of a tummy tuck as well.

Dr. Barry Eppley

Indianapolis, Indiana

Q:  Dr. Eppley, I am wanting to get the size of mons pubis reduced. I am so ashamed of its size and it restricts me from doing many things in my life. I am not obese or grossly fat, just about 30 lbs overweight. I have been losing weight but the mons will just not go down in size to any significant degree. I will continue to diet and exercise but I have no confidence that it will get any smaller. The skin tone over the mound is good and not loose. It feels firm but can be pushed in so I feel certain that it is fat and not bone. If liposuction is done and the fat from the mons reduced will that in any way affect sensation in this area?

A: Liposuction of the mons pubis or suprapubic liposuction is a very successful spot area of fat removal. It can be surprising how much fat is in the mons and how much of a difference it can make when it is done. Like all body areas treated by liposuction, there will be some temporary numbness of the overlying skin for up to six to eight weeks after surgery. This loss of skin sensation will completely return. The procedure will not, however, affect any feeling of the clitoris or sexual sensation. I have even had a few patients who have told me that their sexual sensation was actually improved after mons reduction, presumably due to an uncovering of the clitoris. Suprapubic mound reduction in men can have a similar effect due to exposure of greater penile length.

Dr. Barry Eppley

Indianapolis, Indiana