In brief
Monsplasty, or pubic lift, is the intimate surgery procedure that reduces and lifts the mons pubis, the pad of fat and skin above the pubic bone, when it is too bulky or sagging. It is performed with liposuction, with removal of excess skin or, more often, with both. It is indicated above all after major weight loss, pregnancies or an abdominoplasty that has not corrected the pubic area.
What monsplasty is
The mons pubis (mons pubis) is a fibro-fatty pad located above the pubic symphysis. Over time, after large changes in weight or after pregnancies, it can undergo two changes, often together:
- Localised fat accumulation, which resists diet and exercise.
- Skin laxity (ptosis), which creates a sagging fold towards the vulva.
Monsplasty corrects these two aspects: it removes the excess fat, removes the surplus skin and re-anchors the superficial tissues to the deep fascia of the abdomen, so as to give the pubic area a flatter, more proportionate contour. It is an intimate surgery and body-contouring procedure.
When it is indicated
The indication arises from functional, hygiene-related and aesthetic needs:
- After major weight loss, including after bariatric surgery: the skin of the pubic area remains lax and sagging.
- After a caesarean section: the scar can "anchor" the deep tissues and create a step, making the mons pubis more prominent above it.
- Functional discomfort: rubbing, irritation and maceration of the skin during sport or with tight clothing, difficulty with intimate hygiene.
- After or together with an abdominoplasty: abdominoplasty tightens the abdominal wall but does not directly lift the pubic area, which may look out of proportion or pushed downwards compared with the new flat abdomen.
A side effect often reported is that, by reducing the pubic pad, the tissues are closer together during intercourse, with a possible benefit to comfort. This is an additional effect, not the aim of the procedure.
The techniques: liposuction, excision or a combined approach
The technique is chosen according to how much fat there is and how elastic the skin is:
| Technique | Main indication | How it is performed |
|---|---|---|
| Liposuction alone | Excess fat with skin that is still elastic | The fat is aspirated with microcannulas through small holes, without extensive incisions |
| Surgical excision (pubic lift) | Mainly excess or sagging skin, without a large accumulation of fat | A diamond-shaped area of skin is removed; the scar is placed in the crease above the pubic area |
| Combined technique (lipo-monsplasty) | Localised fat and lax skin together, the most frequent case | Liposuction of the pad, removal of excess skin and anchoring of the tissues to the deep fascia |
Anaesthesia and duration
I perform the procedure as an outpatient, under local anaesthesia with sedation. For the anaesthesia I use Klein's solution, a dilute anaesthetic solution that is infiltrated into the fatty tissue and also reduces bleeding. The procedure generally lasts one to two hours and does not require drains.
Associated procedures
Monsplasty is often combined with abdominoplasty or lipoabdominoplasty, with liposuction of the abdomen and flanks, or with a programme of combined intimate surgery, for example with labiaplasty or with augmentation or correction of the labia majora. It can also be performed on its own.
How much to lift
Excessive lifting can "pull" the labia majora and the clitoral hood upwards, altering the natural appearance of the vulva. For this reason the correction is planned with moderation, assessing the pubic area together with the external genitalia and the abdomen.
Prima comprendere («Understand first»): the consultation
At the first consultation, which lasts from half an hour to an hour, I ask what bothers you, whether you have had large changes in weight, pregnancies or abdominal surgery, and whether your weight is stable: after weight loss it is better to wait until it has stabilised. Then I examine the area standing and lying down, together with the abdomen and the external genitalia, because the mons pubis has to be judged as a whole.
Recovery
The timings are approximate and are confirmed at the consultation, also depending on any associated procedures:
- First few days: swelling and bruising, controlled with painkillers. Unlike other liposculpture procedures, after monsplasty I do not have patients wear a compression garment.
- Work: after about 2 days.
- Sport: after about 2 weeks.
- Sexual intercourse: after about 4 weeks.
- Final result: the new contour is visible immediately, but it settles after 3–6 months, when the swelling has resolved completely.
Risks and complications
General risks, common to any surgery
- Bleeding or haematoma
- Infection, wound dehiscence (partial reopening of the wound)
- Anaesthesia-related complications
Specific risks
- Seroma: a collection of fluid under the skin, more frequent when combined with abdominoplasty; sometimes it has to be drained with a syringe during follow-up visits.
- Prolonged swelling of the pubic area and labia majora, which can last for weeks.
- Scar: usually hidden in the crease above the pubic area and under the underwear, but always present; it may widen or thicken.
- Asymmetries or irregularities of the contour, especially after liposuction, sometimes correctable with a touch-up.
- Changes in sensation of the skin of the pubic area, usually temporary.
- Excessive lifting, with a change in the position of the labia majora and clitoral hood.
- Dissatisfaction, especially when expectations were not clarified beforehand.
What the literature says
Monsplasty has long been described as an integral part of abdominal contouring surgery. Matarasso and Wallach (2001), evaluating 400 patients, proposed treating the abdomen by "aesthetic units", including the mons pubis, to obtain more proportionate results. El-Khatib (2010) proposed a classification of mons pubis ptosis with a treatment strategy for each grade, from liposuction to excision. Alter (2009) described the combined correction of the pubic area and labia majora after massive weight loss, taking care not to damage the structures of the vulva. These are mostly descriptions of techniques and case series: controlled studies are lacking, and data on complications of monsplasty performed alone are still limited.
Frequently asked questions
What is monsplasty?
It is the intimate surgery procedure that reduces and lifts the mons pubis, removing excess fat and skin above the pubic bone to restore a flatter, more proportionate contour.
Can the mons pubis be treated with liposuction alone?
Yes, if the problem is mainly fat and the skin is still elastic. If the skin is lax or sagging, it also has to be removed, otherwise after liposuction it risks sagging even more.
Will the scar be visible?
It is placed horizontally in the crease above the pubic area, usually hidden by underwear or a swimsuit, often along the line of a caesarean scar or an abdominoplasty scar. It is always present and in some cases it may widen or thicken.
Can it be combined with abdominoplasty?
Yes, and it is very common, especially after significant weight loss or pregnancies: it prevents the pubic area from looking out of proportion with the new flat abdomen.
How long does recovery take?
Most people return to work after about 2 days, to sport after about 2 weeks and to sexual intercourse after about 4 weeks. A compression garment is not needed. The final result is assessed after 3–6 months.
How long does the procedure take?
Generally one to two hours, as an outpatient procedure, under local anaesthesia with sedation and without drains; longer if combined with other procedures.
Is monsplasty useful for men too?
Yes. A prominent mons pubis can hide part of the penis: reducing it improves the visible length without any intervention on the penis.
What are the main risks?
Haematoma, seroma, infection, prolonged swelling, a noticeable scar, asymmetries and, if the correction is excessive, a change in the position of the labia majora. We discuss all of these before deciding.
Scientific bibliography
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Matarasso A, Wallach SG – Abdominal contour surgery: treating all aesthetic units, including the mons pubis
Source: Aesthetic Surgery Journal, 2001 – Oxford Academic
What it covers: in 400 patients, the authors propose treating the abdomen by aesthetic units, including the mons pubis, with liposuction and targeted excisions, obtaining more harmonious results.
Why it matters: it is the work that made the mons pubis a part to be always assessed in abdominal surgery.
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El-Khatib HA – Mons pubis ptosis: classification and strategy for treatment
Source: Aesthetic Plastic Surgery, 2010 – Springer
What it covers: proposes a classification of mons pubis ptosis into grades, with the most suitable technique for each, from liposuction to skin excision.
Why it matters: it is the basis for the choice between liposuction, excision and the combined technique described on this page.
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Alter GJ – Management of the mons pubis and labia majora in the massive weight loss patient
Source: Aesthetic Surgery Journal, 2009 – Oxford Academic
What it covers: describes the combined correction of the mons pubis and labia majora after massive weight loss, with lifting, fat excision, liposuction and anchoring of the tissues to the rectus muscle fascia.
Why it matters: it documents the functional benefits, for hygiene and intercourse, and the care needed not to damage the structures of the vulva.
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Cleveland Clinic – Monsplasty (pubic lift): surgery, recovery and scars
Source: patient information leaflet – Cleveland Clinic
What it covers: describes in simple terms the indications, procedure, recovery and scars of monsplasty.
Why it matters: it is an authoritative hospital source written for the general public, for those who want an informative second opinion.
For a deeper look at the whole field of female intimate surgery:
Medically reviewed by Dr Giulio Maria Maggi, Plastic Surgeon — last review:
Article written by
Dr Giulio Maria Maggi
Aesthetic Plastic Surgeon — Turin, Asti and Alessandria
Medical Director — Aesthetic Clinic (Turin)
Registered with the Turin Medical Council (Ordine dei Medici di Torino) no. 20595
Full Member of AICPE (Italian Association of Aesthetic Plastic Surgery) (verify)
Expertise and fields of interest
Dr Maggi gained specific training in intimate medicine and surgery by working for 12 years alongside Prof. Renato Marten Perolino, urologist and plastic surgeon, at Villa Maria Pia Hospital and, privately, at Clinica Fornaca and Clinica Cellini in Turin. From him he learned male-to-female gender-affirming surgery and he was first operator in breast augmentation procedures on Prof. Perolino's patients undergoing gender transition. He also trained internationally with Prof. José Guerrero Santos in Guadalajara and with Prof. Andrew A. Jacono in New York, for the Deep Plane Facelift technique.
He is particularly dedicated to:
- Functional and aesthetic intimate surgery, male and female
- Deep Plane facelift
- Blepharoplasty
- Liposculpture and fat grafting (lipofilling)
- Breast surgery
- Body contouring
Clinical approach: «Prima comprendere» ("Understand first"). No promises of results: indications, risks and limits explained frankly, so that every patient can make a truly informed choice.
