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Weight gain and loss, pregnancy, and aging  all contribute to a sagging abdominal area…and often the pubis as well. Even after a tummy tuck or abdominal panniculectomy, the pubic area can be left full and with some sag. The abdomen may be quite flat above the tummy tuck scar, but the pubis or mons region can be left bulging outward. Many patients are not aware that the pubic area can be flattened and/or lifted.

Pubic lifts or mons pubis rejuvenation is a tuck of a sagging pubic area.  The mons pubis is the hair-bearing area of the pubis. Fullness and sagging of this area affects both men and women. At the least, it can produce an unattractive bulge for women that is visible in clothes. At the worst, its overhang can obscure the female urethra and a portion of the male penis.

In my Indianapolis plastic surgery practice, whenever I do an abdominoplasty I evaluate the appearance of the pubis to determine whether or not the pubic area needs to be lifted. In some cases, the pubic area can be defatted at the time of tummy tuck closure. Or it can be liposuctioned after closure. If there is significant sag, I will extend the level of the tummy tuck incision lower into the pubic than beyond it to get a simultaneous pubic lift at the same time.

Many times, however, the bothersome appearance of a pubic bulge or sag may not be obvious until after a tummy tuck or body lift. This can be treated by Smartlipo (laser liposuction) if bulging is the issue or by an isolated public lift. For the pubic lift, this is a simple procedure that removes a strip of skin and fat and the pubic area is then lifted up so that it is closed within the tummy tuck scar. In rare cases, someone may have a pubic sag despite not having a lot of overhanging abdominal skin or not having had a tummy tuck. When a pure pubic lift is done, a caesarian type scar just above the pubic hair is used as the approach for lifting the pubis. This scar heals well as a horizontal scar just above the pubis.

Pubic rejuvenation, through either lifts or liposuction, results in a less obvious and more streamlined pubic area. It can make for a better appearance in clothes and help with urogenital health and function as well.

 Dr. Barry Eppley

Indianapolis, Indiana

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