The pubic area may ‘become larger’ after tummy tuck for a variety of reasons.
If you notice that it is ‘higher’, it may be due to elevation of the mons area. The mons area becomes elevated in most tummy tucks to some degree. If you had a sagging mons area, the lifting can produce a significant difference in the appearance which may be a ‘normal appearance’.
If you did not have a sagging mons area, the tummy tuck can lift it higher than desired. This can be controlled by making the initial tummy tuck markings lower down on the mons area.
Over time, the incision tends to drift downwards to some degree; you are 6 weeks post surgery and it will be many months before this settling is complete.
If you notice that the area is ‘fuller’, it may be due to post operative tummy tuck swelling or residual fat in the mons. In the first few months, it is not unusual for the mons to be fuller due to swelling 6 weeks after tummy tuck; fluid tends to collect in the lowest part of your abdomen because of the effects of gravity. This corresponds to the lower abdomen and mons area.
Give it some time and the swelling 6 weeks after tummy tuck will improve. If you had a fatty mons area prior to tummy tuck surgery, the mons has been lifted, and the tummy tuck has given you a flat tummy; the fatty mons might be more noticeable now. This can be corrected with some liposuction at the time of the surgery, or afterwards.
At this point in your recovery, you may have normal post op changes I recommend you discuss this issue with your surgeon, and wait for the things to settle. (Lawrence Tong, MD, Toronto Plastic Surgeon)
A prominent mos pubis after a tummy tuck usually results fro a combination of factors. Firstly, the pubic skin may be pulled up accentuating the mons. Secondly, the surgeon may have left a little too much fat in the mons giving the appearance of a bulge when you wear clothing ( patients tell me that they feel that they look like a Ken doll). The solution to the problem is to do additional liposuction to this area to flatten it, and to make it ‘flow’ with the upper abdomen. Sometimes, if your surgery was performed within the last few months, the mons may just be swollen, either diffusely, or with an isolated fluid collection. Time and possible a compression garment may be helpful. If a discrete fluid collection is present, aspiration with a needle may solve the problem. I suggest you speak to your operating surgeon about your issue. (Wilfred Brown, MD, Fairfield Plastic Surgeon)
Careful planning of the location of the Abdominoplasty incision is critical to the final location of the scar. Several factors may influence the choice made by the surgeon, such as the presence or absence of a previous lower pelvic scar from C-Section, or the amount of central and upper abdominal laxity.
Although some tightening and lifting of the mons is desirable, excessive lifting of the mons, or a mons that is too thick relative to the new abdominal skin and fat now located above it, is undesirable. As a general rule, the lower the incision can be placed, the more well-hidden the final scar will be beneath undergarments, low-rise jeans, or bikini-bottoms.
A mons that is too thick may benefit from liposuction to bring down the contour. If the pubic hair (and the abdominoplasty scar) is too high, laser hair removal is an option to lower the pubic hairline. Some patients also consider tattooing of the incision if it cannot otherwise be camouflaged because of an unfavorably high location. (Athleo Louis Cambre, MD, Los Angeles Plastic Surgeon)
When I perform a tummy tuck I always try to bring the scar down as low as possible because the pubic skin and pubic mound tend to be elevated by tension from the upper abdominal skin. I will often take a layer of fat out from under the pubis as well to help it look thinner and to help it line up with the thickness of the upper abdominal skin.
If you have already had your tummy tuck you may wish to discuss liposuction of the pubic area as a next best alternative. (Adam Tattelbaum, MD, Washington DC Plastic Surgeon)
This, unfortunately, is LIKELY to happen unless the area is specifically treated.
Of course, each situation is different and it is nearly impossible to generalize with any accuracy for a specific patient. But if you’re having skin and fat removed from some areas and not others, it’s not surprising that if even a small amount of weight is put on later, it will go to the remaining “pockets” of fat. If the mons pubis (pubic area) was a little full before and/or was not treated during the surgery (removal of excess skin, fat or both; either with direct excision, liposuction or a combination) then it’s not too surprising that it has become fuller after the surgery.
The best approach is to speak to your PS and see if a small amount of lipo can be done now. It’s not THAT big a procedure (easy for me to say!) and it may help the balance of the abdominal region.
And if you’ve put on a significant amount of weight since the surgery, then I would advise losing that weight, or as much of it as you can, before considering having additional surgery.
This condition can occur if the pubic area is fuller or fatter than the previously performed tummy tuck. If this is the case you may ask your Plastic Surgeon to consider liposuctioning the pubic area. I can’t be sure of this without examining you, but this differrence in thickness can often occur after abdominoplasties.
You may also initially have some swelling in that area and this should settle in several months. If not, try liposuctioning the area. (Francis (Frank) William Rieger, MD, Tampa Plastic Surgeon)
The shape and contour of the mons (pubic hair area) should be addressed by your surgeon in your discussions before surgery and treated during surgery. It is not unusual to have some swelling 6 weeks after tummy tuck in that area for weeks to months after surgery, if it persists for more that six months, it is likely due to residual fat and can often be treated with liposuction which should be done during the tummy tuck.
It is not unusual for the pubic hair line to be pulled up after a tummy tuck, particularly in someone who does not have a lot of extra skin to pull down in the first place or in someone who naturally has a high umbilicus on the abdomen. In these circumstances, once again, you surgeon should warn you ahead of time that this may happen. After surgery, to correct this problem, laser hair removal can be used to lower the hair line as long as the hair is dark. In the event that, after all of the swelling 6 weeks after tummy tuck has gone down and the skin has relaxed, you have some extra skin left below your belly button, some of the hair-bearing skin below your scar can be removed to lower the hair line. (James McMahan, MD, Columbus Plastic Surgeon)