Your Questions
Your Questions
Q: Dr. Eppley, I am interested in learning about suprapubic liposuction. I’ve been searching for answers for my 8 year old son for 8 years. He has a buried penis. He has had two surgeries already when he was 2, which rearranged the skin on his penis to have it appear normal looking, however nothing was done with the suprapubic fat pad. It took me two years to finally get someone to acknowledge that there was actually a problem with my son’s penis. He was a stalky baby weighing nearly 9lbs, and I was told he would lose the mound when he grew and was a toddler. He didn’t, he’s still a stalky child, very active but never loses the mound. His penis is totally hidden, but can be exposed if he pushes the fat pad down around it. He is active in hockey and baseball and is getting to the age where it needs to be addressed before he starts getting ridiculed by his peers. I would really y appreciate any information you could give me regarding this procedure.
A: Suprapubic liposuction can very helpful in children and adults with a buried penis problem. The suprapubic mound is a common companion of the buried penis problem. It is not fat that is responsive to weight loss nor will it go away as one gets older. Suprapubic mound liposuction can be very effective at reducing the mound and helping get some more penile exposure. There is a limit as to how much penile exposure will occur but the fat mound can be significantly reduced. Suprapubic mound liposuction is a simple outpatient procedure that uses small cannulas to extract the fat through two small groin incisions. (4mms) The recovery is very short although it takes several months for all the swelling and firmness to dissipate from the base of the penis.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have a buried penis problem and was wondering if liposuction of the pubic mound would help. I have always been obese, my last 12 yrs I have been morbidly obese. I remember my penis has always been small I have had sex many times but is very uncomfortable. Normally I have to choose an small lady, but I can remember seeing it better when I was not as obese as I am now. I can feel the erections coming from way inside under the fat and if I push the fat back the penis will pop out .. I can only push so much that I am able to grab it with a full fist not including the head. But if I was to push more I can see that I have an average penis and of course if I don’t push that fat back it goes all the way in and can’t be seen.
A: The buried penis problem is usually multifactorial in what causes it. Certainly a large suprapubic fat pad is one easily identifiable cause and in the obese male can be the major factor. The shape of the suprapubic mound must be looked at carefully to see whether loose skin hanging down may also be a cause in addition to the fat content of the mound. These helps makes the determination as to whether liposuction alone or liposuction combined with a pubic lift may be needed. The other factor in the buried penis is that the penis itself may be part of the problem as well. It may be naturally small or may be tethered down by fibrosis. It may need to be released as well.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I don’t live in Indiana but I haven’t been able to find a plastic surgeon in my state that does the type of procedure you do. I have for my entire life had an extreme amount of fatty tissue in my mons pubis region, even when I was 125 pounds (I’m about 140 pounds now) it was just insane how big of a bulge I have down there. I am in a situation financially where I might be able to afford some type of financing arrangement, some type of payment plan… and if that were a possibility I would be more than happy to make the trip out there to Indianapolis to speak with you! I just want to be able to wear a swim suit or tights or just tight jeans without this source of embarrassment! 🙁 I am 26 years old and this has been a major issue for me ever since I was about 10 or 11. I’d give anything to finally have it reduced and just look in the mirror and feel ‘normal’ although I hate that term. I know nobody else would notice a difference because I’ve gone to such extents to hide it but just for myself I know it would give me something that I need more than anything right now in my life. It would give me the peace of mind to just wear whatever I want to wear, to do things that other people do without thinking about how to hide this part of my body… please, if there is any forseeable way you think I could work out the financial aspect of this pleasse let me know if I can meet with you! I would so appreciate it. Thank you for your time, I hope to hear from you soon…
A: A large suprapubic mound is not uncommon in many women although it is more unusual in thin women. But its presence in an otherwise non-heavy woman suggests that it is here to stay and will not be eliminated by any amount of diet or exercise. Surgical reduction by liposuction can be remarkably effective and a lot of ft can be quickly removed, In some patients, a suprapubic lift with the liposuction may be needed if there are any excess skin issues, But that would seen unlikely with someone of your weight range and stability.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I want to remove excess fat in the pubic and labia area in order to wear pants and bathing suit more comfortably. It is terribly embarrassing when you have this puffiness sticking out in your clothes. I am not overly fat but my pubic area sticks out further than my stomach. What can be done to reduce this area? I have attached a front and side picture for you to see how big it is. Also I would like to know if I qualify for military discount since my husband is a retired Air Force veteran of Gulf War I and my son is active duty Air Force currently.
A: Based on your pictures, you are an excellent candidate for suprapubic mound liposuction. Fat removal in this area can make it quite flat and is a simple and highly successful contouring procedure of a small area. It can be performed under IV sedation as an outpatient procedure. There will be some mild swelling and bruising and it will take about 3 weeks before all goes down and you are in the benefits phase of the procedure. Because of your husband and son, you most certainly would qualify for a discount for the procedure.
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
Q: I underwent suprapubic liposuction one week ago. I was surprised and concerned about how much swelling and bruising I have on my penis, scrotum and inner thighs. There is also a lump at the base of my penis which makes it look shorter than before the surgery. Will this go away and will my penis now be deformed? Will look a long when the swelling and bruising goes away as it did before? Is what I am seeing normal or am I understandably freaking out about what I am seeing? How long will it be before it looks normal again? Will I still be able to get an erection?
A: What you are experiencing is absolutely normal after suprapubic liposuction. Either you have forgotten all therse details of how things will look after for a period of time or you were never properly educated before the procedure. What I tell all males that receive liposuction in the pubic area is that they will have a tremendous amount of bruising and swelling of the penile shaft and scrotum afterwards…usually shockingly so. This will be striking to the man that has not seen it before but normal from my standpoint. When you see your scotum twice as large than normal and bruising at the base of your penis, you will freak out…unless you know that this is completyely normal. Gravity and the scotal pouch drives most bruising and swelling south. It may get so swollen that the penis may become almost completely buried.This will take about 3 weeks to completely go away. From an erection standpoint, it will work just fine as liposuction does not damage (nor is close to) any of the nerves that are responsible for this important function.
Dr. Barry Eppley
Indianapolis Indiana
Q: I had a hysterectomy which led to me having a muffin top right above the pubic area. Is there any surgical procedures that can correct this?
A: Your so-called muffin top is medically known as suprapubic fullness or lipodystrophy. It can commonly occur after a hysterectomy or even after an abdominoplasty or tummy tuck. It actually was always there to begin with but the creation of a scar across the upper suprapubic area, it appears. It is the result of some residual lymphatic obstruction caused by the scar as well as the tightness or indentation of the scar line. Between the scars and the mons, the suprapubic area looks rounder or more full. This can particularly appear after a tummy tuck because the stomach above the scar line is very flat while the suprapubic area is now fuller or more protuberant.
Reduction of the full suprapubic area can be done quite easily. Through the use of liposuction, excess fat is removed and the suprapubic fullness eliminated. This is a very successful procedure that is often done as a follow-up to a tummy tuck should the residual suprapubic fullness be a concern. It is a simple outpatient procedure that can be done under local anesthesia or IV sedation. There is virtually no pain after and no specific physical restrictions. There will be done some postoperative swelling and bruising which often works its way down onto the mons and labia. Within weeks, the swelling and bruising are gone. With the current use of Smartlipo, much of the bruising that used to occur with suprapubic liposuction does not occur.
Dr. Barry Eppley
Indianapolis Indiana