Mons is the mound of fatty tissue over the pubic bone, serving to protect it . It is the triangular hair bearing part of the vulva.
Patients can have excess tissue and complain of a protrusion or fullness in this area. Therefore causing difficulties in dressing , and also lead to negative impact on body image, self-esteem and sexual experience.
Causes and grading
The causes can be due to genetic predisposition or after severe weight loss.
There are grades to this disorder, described by the Pelosi classification to determine the surgical correction needed.
Type 1: mild bulging of the mons without involving the labia majora
Type 2: moderate bulging of the mons extending to the labia majora
Type 3: moderate bulging with involvment of labia majora with ptosis
Type 4: very large bulging below pubic bone and with ptosis
Options of treatment
It can be combined with Tummy tuck surgery or done alone.
The options include liposuction, excision of excess skin , mons lift or a combination of them
Liposuction – suggested in Type 1 and 2 . where the skin quality is good and can retract . The surgical scar will be very minimal and along the lower abdominal crease.
In cases of type 3 – combination of liposuction and cutting of excess skin. The scar will be at the level of lower abdominal crease. But the sagging of the skin over mons can recur once patient is standing and mobile.
Mons lift – the upper part of the mons is dissected, excess skin excised and hitched with sutures to the abdominal fascia. The scar here will be along the lower abdominal crease. The chances of recurrence is minimal.
Sometimes patient with type 4 may require excision of excess skin in labia majora.
Drains maybe placed which will be removed on the evening of surgery.
Post operative complications
Post operative recovery
Patients can be discharged same day of surgery and will be allowed to walk. Exercises after 6 weeks . edema may take 1-2 months to settle. Can return to work the week after surgery.