Mons Pubis Ptosis: Classification and Strategy for Treatment

Obesity and massive weight loss cause bulging and ptosis of the mons pubis. The pubic area can cause an embarrassment to patients. In some cases, the deformity can be seen even under clothing. Ptosis of the mons usually is addressed during abdominoplasty. The author presents a new clinical classification of mons deformity based on the amount of adipose tissue deposit and the degree of ptosis. A strategy of treatment to achieve a proper rejuvenation of mons deformities is provided. Between 2004 and 2009, a total of 132 patients with pendulous bellies and mons pubis deformities underwent abdominoplasty and lifting of the mons. A technique using a dermal-fascial suspension with permanent sutures to hang the weight of the mons skin and subcutaneous tissues on the musculoaponeuretic system of the lower abdomen is described. The age of patients undergoing the operation ranged from 20 to 53 years. During the follow-up period (12-38 months), all the patients by the author, who reviewed their medical charts. A Likert scale and an evaluation questionnaire were used to assess the aesthetic outcome of mons lifting. All the patients who underwent lifting of the mons pubis were free of postoperative contour deformities and had a long-lasting outcome. At this writing, patient satisfaction has remained high. The clinical classification and treatment guidelines reported are designed to provide simple procedures with minimal complications that have tremendously rejuvenated the mons.