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Dr. Barry Eppley

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Surgeon Dr. Barry Eppley

Posts Tagged ‘monsplasty’

Successful Tummy Tuck and Monsplasty Combination in Weight Loss Patients

Tuesday, September 25th, 2012


Tummy tuck or abdominoplasty surgery recontours the waistline area out into the hips. Most tummy tucks do influence the area below the location of the incision line known as the mons pubis.  While it is commonly believed that the upper abdominal skin flap covers the entire area of abdominal tissue excision in a tummy tuck, the reality is that some of the defect excision is covered by the lower skin flap being lifted. This always has the potential of affecting the mons pubis.

While the mons can be affected by pregnancy, it is most changed when one undergoes significant weight loss. With the weight loss, the pubic area becomes deflated as well causing it to sag and remain full. It may sag enough that it interferes with the urinary stream as well as sexual function.  Lifting of the mons can be incorporated into a tummy tuck design by changing the location of the lower incision and suspending and thinning of the mons concurrently.

While a monsplasty is relatively easy to perform and visually appears to be highly successful, no study has ever been performed on its outcomes. In the September issue of Aesthetic Surgery Journal, a study was published on the cosmetic and functional results after monsplasty in patients who had lost more than 50 lbs. Over 50 female patients who underwent tummy tuck surgery and were at least 3 months after surgery constituted the study population. Patients completed a satisfaction survey looking at parameters of appearance, genital visualization, hygiene and sexual function.

The average weight of the abdominal tissue removed was between 1 and 5 kgs. (average 3.25 kg) Visualization of the genitalia improved in every patient, ranging anywhere from 25% to 100%. Patients rated the appearance of their mons on a scale of 1 to 10 as 3.2 prior to surgery and 8.6 after surgery. Hygiene improved in over 60% of the patients and sex life improved in over 50% of patients. Interestingly, nearly one-third of the patients reported increased genital sensitivity. A decrease in incontinence and a change in urinary stream also occurred in some patients.

Much like plastic surgeons see and hear from patients, a monsplasty is equated with high levels of patient satisfaction as well as functional improvement. Given that a monsplasty adds little risk of complications to a tummy tuck and avoids the need for a secondary procedure, it should be employed in most every massive weight loss patient.

Dr. Barry Eppley

Indianapolis, Indiana

Pubic Lifts (Monsplasty) in Extreme Weight Loss Women

Sunday, December 28th, 2008

One area of sagging skin in the abdominal region that is not frequently addressed is in the pubic or mons area. Although a tummy tuck or body lift removes a lot of loose abdominal skin, it can still leave excess pubic skin behind resulting in a mons sag. This is often disturbing for patients as they did not anticipate this residual problem. In some, this sagging pubic skin is significant enough that it may interfere with intimacy or the urinary stream in some female patients.  Mainly, however, it is just a cosmetic problem with a mismatched sagging pubic mound sitting below the horizontal abdominal scar from their abdominal contouring surgery.

A pubic lift (monsplasty) can be incorporated as part of a body lift or tummy tuck. I use a more inferior placement of the lower central abdominal incision when performing a body lift or tummy tuck so that the sagging pubic area (if present) gets lifted more than the surrounding areas.  This is a simple modification of the frontal abdominal excision that may 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. One of the cosmetic ‘problems’ that this modification will create, however,  is the the buffer zone between the final incision/scar and the pubic hair line is lost. The pubic hairline will be brought right up to the scar line. This can be easily remedied later by laser hair removal.

If a sagging mons area exists after a tummy tuck or an abdominal panniculectomy, it can be lifted by a fairly minor operation later. An inverted U-shaped cutout pattern is done starting at the existing lower abdominal incision. The extra loose skin is removed so that the sagging part of the pubic area is brought up to the scar. The same problem with connecting the upper part of the pubic hairline with the horizontal abdominal after will result also.

Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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