The mons pubis forms the upper boundary of the vulva with the labia majora on both sides. The mons pubis is a prominent cushion of hair-bearing skin and subcutaneous fat overlying the pubic bone.
The epidemic of female obesity along with massive weight loss has resulted in the common complaints of an excessive mons pubis fat deposit and descent of the pubic hair, introitus (vaginal opening), and labia majora.
Pubic fat is often seen as a congenital deformity, which will not resolve with weight loss alone. The woman complains of an unsightly bulge or protrusion with loss of self-esteem, often leading to avoidance of wearing tight clothes or bathing suits. The large mons pubis fat deposit is often also associated with large, protuberant labia majora due to fat excess with skin stretching. Weight loss rarely results in elimination of these deformities, so surgical treatment is required.
PUBIC LIPOSUCTION:If there is no excess skin or if a pubic lift is not necessary, then pubic liposuction can eliminate the fat deposit. Usually liposuction is performed through small stab incisions in the groin creases. The upper labia majora are usually also suctioned.
PUBIC LIFT:Traditional reduction of an enlarged mons pubis fat pad with skin descent has been a horizontal skin excision and fat resection with a skin lift. This has often been combined with liposuction and / or tummy tuck. A natural-appearing mons reduction and lift can be achieved with a horizontal skin excision below the hanging abdominal skin line; liposuction of the mons pubis, upper labia majora, and groin fat; and fat excision of the residual deforming fat pad.
OUTCOME:The patients are generally extremely happy with elimination of the pubic protrusion. It is uncommon to have an unhappy patient as long as the postoperative result and limitations are explained and shown to the patient.