The mons is the area between the pubic bone and the labia, or the pubic area. Some patients feel the area is too full or droopy with age or change in weight. There are a number of different ways to treat the mons, including liposuction, direct excision of excess fat or skin of the mons, and/or lifting of the mons. Many patients note excess skin and volume in this area after weight loss, and the area is commonly addressed at the same time as a tummy tuck. Often if it is not included in the same surgery, female patients find it embarrassing to have fullness in the area, worried it looks like they are a male in that region when in clothing. Which of the treatments is best will vary patient to patient. Common reasons to treat the mons:
- Unwanted fullness to the mons
- “Mons pannus” or separate focal overhanging mons area
- Excess skin of the mons
- Excess drooping of the mons
WHO IS NOT A CANDIDATE?
Liposuction alone may not be appropriate for patients with excess skin (unless skin excision is planned). Following liposuction, your skin is left to contract (or shrink) around the remaining smaller volume. If you have good quality skin, this will happen over time as you heal. If your skin is loose or of poor quality to start, it will not predictably contract. In these cases, liposuction could actually make you look worse, since now you will be left with drooping skin. In cases where there is excess skin, looseness or drooping, and excess fat, a direct excision involving reducing and/ or lifting of the mons is recommended.
HOW BIG ARE THE INCISIONS?
The incisions used in liposuction are very small, only a few millimeters long, and are typically closed with a single stitch at the end of the procedure. For liposuction of the mons, the incisions can typically be hidden in the groin crease. The incisions tend to heal well and are not noticeable, however results will vary in each patient according to how their body heals.
The incision used for reduction of the mons or lifting of the mons is typically a horizontal incision at the upper border of the mons to be retained. The incisions may also extend along the groin creases if there is excess in the horizontal dimension, not just vertical excess. Often the horizontal incision is made 6-8 centimeters above the upper border of the labia crease, so that the hair-bearing skin is not advanced too far up onto the abdomen. When a tummy tuck is being done at the same time, the skin in between the upper border of the mons and lower border of the abdominal incision is brought together, so that there is only one low horizontal incision in this area.
RISKS OF THE PROCEDURE?
Standard risks of having includes: Pain; bleeding; infection; scarring; painful or hypertrophic scarring; hematoma; seroma; injury to vessels, nerves, any surrounding structures; prolonged swelling; contour irregularity; poor cosmetic result; asymmetry; need for further procedure; risks of anesthesia.
POSTOPERATIVE FOLLOW-UP VISITS
Visits following liposuction surgery typically occur the day after surgery (for dressing change and making sure there were no issues overnight), the week after surgery (for removal of drains if present), 2 weeks after that, and then spread out less frequently thereafter. The schedule is adjusted based on doctor/patient preferences and needs.
Walking the day of surgery is recommended. You may shower 24 hours after surgery, preferably with a watertight dressing over the incision during the shower. No baths, soaking in tubs, hot tubs, or swimming pools until incisions are fully healed. Gentle soap (non-perfumed, non-irritating soap preferred) and water over the incision is okay. Scar gel may be used starting 2 weeks after surgery on the incisions. Early in the recovery process, the areas may feel as full or even fuller than they were before, and this is due to swelling. The early round of swelling usually improves over 3 weeks, but there is still edema that will resolve over the next several months. In general, avoiding full exercise for 6 weeks following surgery, at which time you can ease back into your workouts. You may notice swelling after workouts. You may return to work the week after surgery, depending on your pain level, stamina, and activities required in your occupation. You may drive once you are no longer taking pain medications or muscle relaxers, and allow a 24 hour minimum window between your last pain medication or muscle relaxant dose and driving. All recovery processes and recommendations vary patient to patient, so these general guidelines may not apply to every patient.