Q: Dr. Eppley, I am interested in pubic liposuction. I have an enlarged mons pubis and always have. It sticks out, is soft and doughy and protrudes further than my stomach. I wonder if my pelvic bones are at the wrong angle. My mound has really no sensation which I assume is because it is just a mound of fat. This is very embarrassing as I am small and thin with a weight of 104 lbs at 5’ 2” tall. While my weight fluctuates a little, there is no change in the size of the pubic mound. I am assuming that some form of liposuction is the best method to reduce this mound to a flatter profile.
A: A protrusive pubic mound is a not uncommon problem for many women. It is most frequently seen after a tummy tuck where the waistline is the most narrow circumferential area and a residual pubic mound (not recognized before surgery) now sticks out further than most of the stomach. It can also be seen in very thin women who naturally have a thicker fibrofatty layer on their pubic mound. This type of fat is not responsive to weight changes as it has a protective padding purpose and not a metabolic fat depot role.
You are correct in assuming that pubic mound liposuction is the definitive treatment. While much is made of the type of liposuction used, the reality is that ‘simple’ non-energy based liposuction will work just as well. The key is that it must be of the small cannula variety since the area is so small. This discrete type of small fat removal does fall into the moniker of ‘liposculpture’.
Pubic mound liposuction can be done under local or IV sedation, takes less than one hour to do, and involves very little recovery. One needs to be aware that there will be some bruising and swelling of the mound and labia and that it will take several months until the pubic area feels soft and normal again.
Dr. Barry Eppley
Q: Dr. Eppley, I am 42 years old and had a tummy tuck two years ago after my third and final child. While I had some rather dramatic improvement and am pleases with the overall result, there is one area that still remains problematic. I have this persistent swelling between my tummy tuck scar and the pubic bone. It has never gone down completely and I don’t understand why. It sticks out in dresses and tight pants like a bulge and is a visible ledge if I try and wear a swimsuit. What can I do to get rid of this swelling?
A: What you have is not swelling and is a not uncommon finding for some patients after a tummy tuck. It is residual fat in the pubic mound area that is below the effect of a tummy tuck. The tummy tuck scar in most patients becomes the narrowest part of the waistline and can look like a constricting band above the puffy pubic mound. Sometimes this is recognized before the tummy tuck and its reduction by liposuction done at the same time. In others, it becomes obvious after a tummy tuck. It can be very effectively reduced with a small liposuction procedure. (pubic mound liposuction)
Dr. Barry Eppley