Mons Lift with Tummy Tuck : Patient #1884504

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After discussing the options including doing nothing, deep dermal heating, isolated laser lipolysis, and diet and exercise, the patient has elected to pursue abdominoplasty with diastases repair and umbilical transposition. I reviewed drain placement and care. At the same time, we will perform a mons lift.

Patient Overview:

Patient was unhappy with their waist and thighs. They do not exercise and have had no prior treatment. The upper abdomen shows mild adiposity, striae, diastases with moderate laxity. The upper abdomen shows moderate adiposity laxity and prolapse. There is mild diastases with thick striae. The flanks and low back show moderate adiposity with mild laxity as do the inner and outer thighs.

Surgical Case Study:

  • The abdominoplasty incision line was marked. The 10 cm horizontal portion was marked at the hairline. The lateral limbs extended.
    within the tan line to the axis of the anterior iliac spines.
  • An inferior flap elliptical incision was marked with the arc within the 10 cm horizontal portion. The incision line and umbilicus were infiltrated with our standard straight solution. The areas of flap elevation were hydro-dissected using our standard quarter strength tumescent solution. The ports were infiltrated with our standard straight.
    solution. The areas to be treated were infiltrated with our standard quarter strength tumescent solution.
  • The area was prepped and draped in a sterile fashion. The ports were made with an 18-gauge needle. The laser cannula was introduced into the soft tissue and
    activated on a setting of 40 W with an 1000 µm fiber after assuring the patient and all OR personnel had adequate eye protection. The 1064 nm laser was used throughout. Great care was taken to treat all layers of fat deeper than 1 cm to a uniform temperature of 55°C deep and 42 °C in the immediate hypodermis. A 5 mm bucket cannula was used in the deep subcutaneous tissue. A 3 mm aspiration cannula with 1 mm ports was used for the more superficial layers. The ports were closed using subcuticular 4-0
    chromic. The Smartsense and Thermaguide were utilized throughout the procedure.
  • The abdominoplasty incision was made. This was taken down to Scarpa’s fascia. Superior elevation was performed over Scarpa’s
    fascia to the level above the costal margin. The umbilical stalk was isolated and transected from the flap as it was reached. The
    umbilical stalk was anchored using 0-PDS. The diastases was repaired from the pubis to the xiphoid process using #2 polypropylene
    Quill sutures. 4 layers of the suture were placed.
  • The superior flap was redraped and the site of the neo-umbilicus was marked in the midline in a inverted U fashion. The umbilical stalk was brought through the neo-umbilicus and fixed using deep 3-0 PDS followed by cutaneous 4-0 Monocryl. Vertical progressive retention sutures of 2-0 PDO Quill were placed along the lateral borders
    of the rectus muscles and the flap pausing to perform the umbilical transposition.
  • The inferior elliptical incision was then excised from the inferior flap. A 4 mm JP drain was placed and brought out of the inferior flap. The superior flap was anchored to the pubic periosteum using 0-PDS.The flaps were redraped and excess soft tissue excised. The wound bed was sprayed with 10 cc of platelet rich plasma.
  • The incision was then closed with 2 layers of deep 2-0 PDO followed by cuticular 4-0 Monocryl removing the dog ears on the lateral ends. Mastisol and brown tape were placed over the incisions.
  • A compression garment was placed. The patient was awoken and taken to the recovery room in stable condition.

A mons lift, also known as a monsplasty or pubic lift, is a cosmetic surgical procedure designed to address sagging or excess skin in the mons pubis area. The mons pubis is the mound of fatty tissue located above the pubic bone and just below the abdomen.

Some individuals may experience changes in the appearance of their mons pubis due to factors such as weight fluctuations, pregnancy, or aging. As a result, they may develop sagging or loose skin in this area, which can be a source of discomfort or self-consciousness.

During a mons lift procedure, a plastic surgeon will make incisions in the mons pubis region to remove excess skin and fat, if necessary. The surgeon will then reposition and tighten the remaining tissues to create a more aesthetically pleasing contour. The goal of a mons lift is to achieve a smoother, flatter, and more youthful appearance in the mons pubis area.

A mons lift is often performed in combination with other cosmetic procedures, such as a tummy tuck or liposuction, to achieve an overall harmonious result in the abdominal and pelvic regions. However, it can also be performed as a standalone procedure depending on the individual’s specific needs and goals.