Q: Dr. Eppley, I have had several children and am wanting to get my stomach back in shape. I am only 26 years old and I don’t want to live the rest of my life with this stomach. I am too young for that! My question is what will happen to my pubic area after a tummy tuck. I noticed that it got bigger after having children and I would like to see that area flatter as well. Will it be taken care of if I get a tummy tuck? Also I have love handles that I would like to get rid of as well. Will a tummy tuck get rid of those as well?
A: A tummy tuck will only solve the problems that lie within its zone of tissue excision. When looking at the markings of a tummy tuck, you will see that the love handles and the pubic area lies outside the excision zone. However, the addition of flank liposuction is a part of most tummy tucks with the recognition that the goal is an extended waistline reshaping that wraps around to the back. Pubic or mons reduction, if needed, can be incorporated as part of the tummy tuck procedure whether it is reduced with liposuction or it is lifted as part of the tummy tuck design. You can see in planning a tummy tuck that the entire area must be taken into consideration to get the best overall result.
Dr. Barry Eppley
Q: Dr. Eppley, I had a belt lipectomy six months ago. The tummy tuck portion in the front did lift my pubic area a bit but it is still puffs out below the scar line compared to the tight abdomen above it. When I lay on my side, my abdomen is tight but the pubic area is puffy and sags like old wrinkled skin. While standing it just looks a bit puffy but no wrinkles. What pubic reduction method would work the best and can it be done under local anesthesia?
A: It is not uncommon that pubic or mons fullness becomes evident after a tummy tuck or curcumferential lower body lift. While this fullness was always there, it becomes apparent when the tightness of the scar above it is more narrow than the original projection of the pubic tissue. Every tummy tuck does create some degree of a pubic lift but it may not be enough to obscure the larger pubic mounds that exist in those that need a circumferential body lift. If this is diagnosed in advance, it can be incorporated into the frontal tummy tuck design or undergo liposuction for reduction. On a secondary basis, pubic reduction can be done liposuction alone or combined with a pubic lift skin excision pattern. Since it appears by your description that you need more than just liposuction, I would recommend a general anesthesia approach.
Dr. Barry Eppley