Yes, the bulge of fatty tissue above the pubic bone, often referred to by the acronym FUPA, can be surgically reduced and removed. The area itself is anatomically known as the mons pubis. This type of body contouring procedure is a common offering in plastic surgery practices, particularly for patients who have experienced significant weight loss or post-pregnancy changes. Surgical procedures specifically target the excess fat and/or skin in this region to create a flatter, smoother contour. The decision on the best surgical approach depends entirely on the specific composition of the tissue in the area.
Understanding the Mons Pubis Area
The mons pubis is a mound of adipose (fatty) tissue located directly over the pubic bone. While this area serves as a protective cushion, the fat present is often resistant to diet and exercise. These fat deposits are often hormone-dependent, meaning they can accumulate even when overall body weight is stable.
Enlargement can result from genetics, the natural aging process, and hormonal shifts. Significant weight gain followed by weight loss frequently leads to both excess fat and loose, inelastic skin. Post-pregnancy changes can also cause the area to droop or protrude noticeably, potentially causing discomfort, poor clothing fit, or hygiene challenges.
Surgical Procedures for Removal
The surgical approach depends on whether the primary concern is excess fat, excess skin, or a combination. When the issue is predominantly localized fat and the overlying skin retains good elasticity, liposuction alone is often appropriate. During liposuction, a thin tube called a cannula is inserted through small incisions near the pubic hairline to suction out the excess adipose tissue. This technique results in minimal scarring, often hidden within the pubic hair.
When significant skin laxity or sagging exists alongside excess fat, a more involved procedure called a monsplasty, or pubic lift, is required. A monsplasty involves surgical excision to remove both the excess skin and the underlying fatty tissue. The surgeon makes an incision, usually horizontally across the lower abdomen or hidden in the pubic crease, to remove a section of skin and fat. The remaining skin is then pulled taut and sutured, which effectively lifts and flattens the mound.
Many patients benefit from a combination of techniques, where liposuction first reduces the bulk of the fat, followed by surgical excision to remove redundant skin. Monsplasty is frequently performed at the same time as an abdominoplasty (tummy tuck), as a bulging mons pubis may become more prominent after the abdomen has been tightened. Combining procedures ensures a cohesive and balanced contour across the entire lower torso. The choice between liposuction, monsplasty, or a combined approach is made during the initial consultation, based on the patient’s specific anatomy and cosmetic goals.
Determining Patient Eligibility
Patients must meet several pre-operative health and lifestyle criteria before undergoing surgical reduction of the mons pubis. Maintaining a stable weight is a primary requirement; patients should not be actively planning to lose or gain significant weight, as future fluctuations can compromise the surgical outcome.
Candidates must be in good overall health and free of pre-existing conditions, such as uncontrolled diabetes or heart disease, that could complicate healing. Smoking is a major contraindication because nicotine restricts blood flow, increasing the risk of poor wound healing and infection. Patients are required to stop smoking for several weeks both before and after the procedure. Having realistic expectations about the final outcome is also important.
Recovery, Risks, and Realistic Outcomes
Recovery varies depending on whether liposuction or a full monsplasty was performed. For liposuction alone, downtime is shorter, with most patients returning to light daily activities within a few days. Monsplasty recovery is more extensive, requiring a return to sedentary work after one to two weeks. Post-operative care involves wearing a compression garment to minimize swelling and support the new contour, and avoiding strenuous exercise or heavy lifting for four to six weeks.
Common risks associated with the surgery include:
- Infection at the incision site.
- An accumulation of fluid (seroma).
- A collection of blood (hematoma).
- Temporary numbness in the area due to nerve manipulation.
Since a monsplasty involves surgical removal of skin, a scar will be present, but surgeons place the incision low on the pubic line so it can be concealed by underwear or swimwear.
The final aesthetic results become apparent after the majority of the swelling subsides, often within six months to a year. The goal is a flatter, smoother profile. The reduction is considered permanent, provided the patient maintains a stable weight following the surgery.