The Pubic Area

The Area Nobody Wants to Talk About – Pubic Area

September 15, 2016

The pubic area is naturally a very private zone for both men and women and is an extremely important part of our body that we need to understand. The pubic mound bulge is visible even with clothes on, however, is somewhat of a taboo or no-no, to even talk about this area.

As both a surgeon specializing in After Weight Loss Surgery and a post-op weight loss patient myself, through this article, my goal is that you have a better understanding of the importance of this life-changing procedure.

What is the Mons Pubis (Pubic Area)?

The mons pubis also known as the pubic area is the fatty tissue located above the pubic bone right on top of the genitalia and works as a cushion to protect the important private parts. It has a huge number of lymphatic vessels which drain its content to the inguinal or groin lymph nodes. This area has very good blood circulation because it flows through numerous arteries and veins to help drain to the external and internal genitalia. And of course, it has uncountable amounts of sensitive nerves.

All of the above features are the reason why this is a very sensitive area, and will be tender and painful after any bump or minor hit.  After any type of surgical procedure which involves the pubic area, there will be swelling and bruising because of gravity.

Because of genetics the pubic area may be nice and flat, or thick and elevated. It is interesting how the pubic area suffers modifications on its volume, elasticity, and appearance through our lives and will be directly impacted by weight changes, genetics, hormonal influence, childbirth, and aging.

What Happens to the Pubic Area During Pregnancy or Obesity?

During pregnancies or obesity, it is common to see varicose veins which make the area even more tender and sensitive. After gaining weight, the pubic area, in most cases, becomes thicker, very obvious and bulges in clothing.  Especially after weight loss, it may become saggy, where the pubic mound bulge turns into a bulky, extremely flaccid area.  For many people, this results in being self-conscious and uncomfortable while wearing tight fitting clothing such as exercise wear, leggings, jeans, swimsuits even some regular clothes.

Among woman after massive weight loss, over and above the embarrassment of the way they look in their clothes, the degree of flaccid skin on the pubic area may make it difficult to urinate and or have intercourse.

For men, the pubic area may “hide and diminish” the real length of the penis, also creating an issue with urinary function and definitely intercourse, becomes a challenge while creating significant embarrassment. This “hidden” area must be taken care of. There are several options to address different scenarios on the pubic area. In patients whose “volume” is the problem, and no flaccid pubic skin is observed, liposuction will be the answer in resolving the problem.

If the problem is the combination of thick volume and a flaccid pubic, then a combination of procedures will be the best option:  Reduction of the pubic area, which is done through liposuction or direct fat removal and a lift by excising excess tissue, is performed through an incision 6-7 cm on top of the labia or the base of the penis, about 8-10 cm length. Then the attachment to the Scarpa Fascia to hold it in place will be needed. Very often a small amount (1-3 cm) of skin resection is also needed. The saggier the pubic area, the larger the amount of skin to be removed.

For Massive Weight Loss Patients, What About a Lift?

Unfortunately, on massive weight loss patients just a lift will not be enough. Some patients develop a severe degree of flaccid pubic skin, and the lift will only leave a very wrinkly incision or scar which may leave the area still bulky and weird in shape. The reason being, the pubic area was overstretched on the length and also on the width, so using the procedures to improve the length, which is the lift, will not be enough.

Techniques which will improve both the width and length of excess skin

1.  The end result will be the horizontal incision and a mid-line incision (vertical) or the horizontal and two lateral vertical incisions in order to significantly reduce the width.

2.  The type of scar on the pubic area is normally thin and smooth.  However, only a few may develop wide, hypertrophic or keloid scars which may be improved by using silicon sheets, silicon gels, massage and a series of corticoids shots.

3.  A drain will be needed due to a large amount of lymphatic fluid produced in the area and will remain for a couple of days if performed as a single procedure.  If done in combination with other procedures such as liposuction, thigh lift, etc. the fluid may be larger and the drain may remain in for 5-7 days.

It is expected to observe swelling, bruising, tenderness, and different degrees of pain after a Pubic Lift because of the vascularization to the area, the large amount of lymphatic circulation, the presence of hair and natural gravity.  By the end of a period of 3-6 weeks, a realistic improvement on the shape, volume, appearance and healthy function will be attained.

A Pubic Lift and rejuvenation is a procedure very often performed on patients and implicit in the same incision during a Tummy Tuck, Abdominoplasty, Lower Body Lift or Fleur de Lis.

This procedure is so very important to both men and women and will always be evaluated and discussed on an individual basis, always keeping safety as the priority with each patient. We are proud to say our patients end up extremely happy, with a renewed self-esteem and confidence, and enjoy a more functional, youthful, natural, and attractive body.

Carmina Cardenas


Dr. Carmina Cardenas is a Board Certified Aesthetic, Plastic and Reconstructive Surgeon. She completed her residency and graduated with honors from the Mexican Institute of Social Security, at the Hospital of Specialties in Plastic and Reconstructive Surgery. She is owner of Beauty Enhance Plastic Surgery.

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