A pubic lift, formally called a monsplasty, is a surgical procedure that removes excess skin and fat from the mons pubis, the rounded mound of tissue just above the pubic bone. The goal is to flatten and tighten this area, improving both appearance and comfort. It’s most commonly sought by people who have loose, hanging tissue after significant weight loss, pregnancy, or aging.
Why the Mons Pubis Changes Shape
The mons pubis sits right at the lower part of your abdomen, over the pubic bone. Like other areas of the body, it stores fat. When you gain weight, fat often accumulates here, and the skin stretches to accommodate it. If you carry that extra weight for a long time, the skin’s collagen fibers lose their ability to snap back into place. The result: even after losing weight, the tissue can sag or bulge.
Three situations most commonly lead to this:
- Significant weight loss. People who lose 50 pounds or more, especially after bariatric surgery, often find that the mons pubis retains loose, hanging skin that no amount of exercise can tighten.
- Pregnancy. Hormonal changes and the physical stretching of pregnancy can permanently alter the skin’s elasticity in this area.
- Aging. Over time, collagen breaks down throughout the body, and the mons pubis is no exception. Gravity pulls the tissue downward, and it can gradually become more prominent.
What the Procedure Involves
A pubic lift uses one or both of two techniques depending on what’s causing the fullness. If the issue is mainly excess fat, liposuction alone may be enough. A small cannula is inserted through a tiny incision to suction out fatty tissue, leaving the area flatter without a large scar.
If the problem is loose, sagging skin rather than just fat, the surgeon removes a section of skin and tightens what remains. This excision approach leaves a longer incision, typically placed low enough to be hidden by underwear or a swimsuit. Many people need a combination of both: liposuction to reduce volume and skin excision to eliminate the sag.
The procedure is usually performed under general anesthesia and takes roughly one to two hours. It can be done as a standalone surgery or combined with other procedures.
Commonly Combined Procedures
A pubic lift is frequently paired with a tummy tuck. Because a tummy tuck already involves an incision across the lower abdomen, surgeons can address the mons pubis through the same approach, lifting and tightening the area as part of a single operation. This combination is especially common after massive weight loss, where both the abdomen and pubic region have significant excess tissue.
Some people also combine a monsplasty with a labiaplasty, which reshapes the labia. While the two procedures target different structures, doing them together allows for a more complete change in a single recovery period. Liposuction of the outer labia can also be performed at the same time.
Who Is a Good Candidate
The best candidates are people whose excess tissue causes physical problems, not just cosmetic concerns. Hanging skin and fat in the mons pubis can trap moisture, leading to chronic rashes, skin infections, and irritation in the folds. Some people find that the bulk of tissue makes it difficult to urinate comfortably or interferes with sexual activity. Others simply feel self-conscious in fitted clothing.
Surgeons generally look for a few baseline health requirements. You should be at a stable weight, meaning you’re not actively losing or gaining. Conditions that impair healing, including uncontrolled diabetes, heart disease, and lung disease, can disqualify you. Smoking is a significant risk factor for poor wound healing, so most surgeons require you to stop for at least two weeks before and two weeks after surgery.
Recovery and What to Expect
Recovery depends on how extensive the surgery was. A liposuction-only procedure has a shorter downtime than one involving skin excision. In general, most people take about one to two weeks off from sedentary work and four to six weeks before returning to strenuous exercise or heavy lifting. Swelling and bruising in the area are normal and can take several weeks to fully resolve.
You’ll likely wear a compression garment over the area for the first few weeks to minimize swelling and support the tissue as it heals. Sexual activity is typically off-limits for at least four to six weeks. The incision site will be tender, and keeping it clean and dry is important for preventing infection. Scars from the excision technique start out pink or red and gradually fade over several months to a year, though they never disappear completely. Their placement low on the abdomen means they’re usually concealed by clothing.
Risks of Surgery
A pubic lift carries the same risks as any surgery: infection, bleeding, and reactions to anesthesia. A few complications are more specific to this procedure. Seromas, which are pockets of fluid that collect under the skin, are relatively common in the groin area and sometimes need to be drained with a needle. Wound separation can occur, particularly in the skin-excision approach, because the groin is a high-movement area that puts tension on the incision. Changes in sensation, including temporary numbness or increased sensitivity around the incision, are also possible and usually improve over time.
Smoking dramatically increases the risk of poor healing and wound complications. This is why the smoking cessation requirement is strict, not optional.
How Long Results Last
The fat cells removed through liposuction are gone permanently, and the skin that’s excised won’t grow back. That said, results aren’t immune to future changes. Significant weight gain can cause new fat to deposit in the mons pubis, and the remaining skin can stretch again. Pregnancy after a pubic lift can also reverse some of the results. For the most durable outcome, surgeons recommend waiting until you’re done having children and at a weight you plan to maintain.
Aging will continue to affect skin elasticity throughout the body, including the mons pubis, but most people find that even years later, the area looks considerably better than it did before surgery.
Insurance Coverage
Most insurance companies classify a pubic lift as cosmetic, which means they won’t cover it. This is true even when the procedure is called a monsplasty and framed in medical terms. Major insurers explicitly list pubic liposuction and lifts as cosmetic procedures. The exception is when there’s documented “significant functional impairment,” such as chronic infections or skin breakdown that hasn’t responded to other treatments. Even then, getting approval requires extensive documentation from your surgeon and isn’t guaranteed. Out-of-pocket costs for a monsplasty typically range from $3,000 to $8,000 depending on the technique used, the surgeon’s experience, and geographic location.