The mons is that prominent pad of fatty tissue that lies over the pubic bone and is covered with hair. Formerly obese patients often have an enlarged mons after weight loss that consists of fatty deposits and excess sagging skin. This tissue will not shrink with additional weight loss or exercise.
An enlarged mons interferes with bathroom and sexual functions, hygiene, comfort, clothing fit, and appearance. Mons reduction, which is typically combined with a circumferential body lift, removes the excess fat and skin.
If an enlarged mons is primarily caused by excess fat deposits, standard liposuction of the area around the pubic bone is usually sufficient to reduce the mons size. If removal of excess skin is also needed, a triangular-shaped wedge of skin and tissue is excised. This procedure requires a separate incision, about 4 inches long, that extends vertically over the mons. (The circumferential body lift incision is horizontal.) Mons reduction takes less than 1 hour so does not greatly increase the time of a circumferential body lift, but it will make a real difference in comfort and function.
For women, the most severe cases of skin, tissue, and fat excess in the pubic region may extend to the labia (the folds of tissue, or “lips,” lying on either side of the vaginal opening). The labia collects fat deposits like every other part of the body. When a large amount of weight is lost, the over-stretched labial tissues may hang in folds and have a major impact on function and hygiene. If this problem is severe, the triangular wedge excision of a mons reduction is extended to include removal of the excess labial tissue. This procedure is known as a labioplasty or labial reduction.
Obesity in men also causes genital problems. If the mons area is very large, the penis may become nearly inverted and must be physically pulled out of surrounding skin folds for urination or sexual activity. This problem is treated with liposuction and mons reduction, usually at the time of a circumferential body lift. In severe cases, a second mons reduction and additional liposuction may be needed to fully treat this deformity.
Surgery in or near the genital region is not without risks and side effects. Skin sensation may be temporarily decreased, but sensitivity of the clitoris may be increased. Prolonged swelling and redness are not unusual following mons reduction or other genital procedures. Your surgeon will explain what to expect if you are interested in mons or labial reduction.