Aesthetic and Functional Satisfaction After Monsplasty in the Massive Weight Loss Population

Background: The mons region is often affected by massive weight loss (MWL), with descent of the pubic area and residual adiposity. Thinning and resuspension are often performed concomitantly with abdominal contouring procedures. Objectives: Assess patient satisfaction, as well as functional and aesthetic results, after monsplasty in the MWL population. Methods: The authors identified 54 consecutive female MWL patients (>= 50 lbs) who had undergone abdominal contouring and completed at least 3 months of follow-up as potential subjects. Subjects were asked to complete a Mons Satisfaction Survey, either by phone or in person. Demographic and procedural data were collected from our prospective registry. Descriptive statistics were calculated with significance set at P value <.05. Results: Thirty-one patients (57.8%) completed the survey. Average patient age was 46 +/- 11.3 years. Mean maximum body mass index (BMI) was 52.0 +/- 8.81 kg/m(2), mean current BMI was 31.0 +/- 6.22 kg/m(2), and mean delta BMI was 20.7 +/- 6.00 kg/m(2). Average pannus resection weight was 3.25 +/- 2.03 kg. Visualization of the genitalia improved from 25.8% to 100% (P <.01). Patients rated the appearance of their mons as 3.18 +/- 2.11 prior to surgery and 8.58 +/- 1.73 after surgery (P<.001) on a scale of 1 to 10. Hygiene improved in 61.3% of patients, and sex life improved in 51.6%, with 32.3% of patients reporting increased genital sensitivity. Incontinence decreased from 22.6% to 12.9%0, and 6 patients reported a change in urinary stream. Conclusions: Monsplasty at the time of abdominal contouring yields significant improvement in patient satisfaction levels and functional scores. With proper incisional design, monsplasty can be performed safely during abdominal contouring with high patient satisfaction to improve both form and function of the pubic region.