Using Superficial Fascial System Suspension for the Management of the Mons Pubis After Massive Weight Loss

Abstract

Although an abundance of literature exists regarding frequently lifted body areas, there are few reports about body contouring of the mons pubis. Therefore, this paper describes the first clinical results from a new technique, which surgically lifts the mons pubis using superficial fascial system suspension. Fifty patients underwent a lower body lift, including a superficial fascial system suspension of the mons pubis. After a mean follow-up period of 16.9 months (range, 6-31 months), patients were evaluated by standardized preoperative and postoperative photographs using the Pittsburgh Rating Scale. In addition, all patients completed a Likert-type scale questionnaire pertaining to body satisfaction and other bodily changes. Scores from the Pittsburgh Rating Scale improved significantly (P=0.03) from 2.76 (0.43) [range, 1-3] preoperative to 0.5 (0.59) [range, 0-2] postoperative. Fifteen (30%) of the patients assessed the new contour as very good, 26 (52%) patients as good. Eight patients developed a temporary edema in the mons pubis and 1 patient developed an infected fascia suture granuloma, which had to be removed. A mons pubis lift with the aid of the superficial fascial system is a safe surgical technique, which can easily be integrated in body contouring surgeries of the torso.

Anatomic update on the 3‐dimensionality of the subdermal septum and its relevance for the pathophysiology of cellulite

“…The soft tissues located deep to the skin are highly organized and structured, rather than arranged as an amorphic mass of homogenous fat spanning the space between the dermal undersurface and the deep fascia (a fascial layer enclosing the entire body) 14–19 . The subcutaneous architecture is designed to provide insulation and protection for the body from temperature, chemical, and mechanical influences.…”

“…The soft tissues located deep to the skin are highly organized and structured, rather than arranged as an amorphic mass of homogenous fat spanning the space between the dermal undersurface and the deep fascia (a fascial layer enclosing the entire body). [14][15][16][17][18][19] The subcutaneous architecture is designed to provide insulation and protection for the body from temperature, chemical, and mechanical influences. Insulation is affected by a layer of fat of variable thickness depending on the body region, whereas mechanical stability is affected by an organized system of connective tissue which has been termed previously as the "superficial fascial system".…”

Joint Report on Terminology for Cosmetic Gynecology

“…Excessive skin and fat are removed by dissecting to the level of the mons pubis fascia along an area bordered superiorly at abdominoplasty or prior scar and inferiorly approximately 5-7 cm above the anterior vulvar commissure. Lateral incision shapes can vary by technique including trapezoidal shape, 74,75 circular arch, 53,76 swallow crescent, 53 sharp triangular wedge, 73,77 and continuous abdominoplasty incisions extending laterally over upper thighs corresponding to parallel abdominoplasty incision 77 . The mons pubis is then anchored to the abdominal fascia with permanent or delayed absorbable sutures 53,73–75,77 …”

“…Lateral incision shapes can vary by technique including trapezoidal shape, 74,75 circular arch, 53,76 swallow crescent, 53 sharp triangular wedge, 73,77 and continuous abdominoplasty incisions extending laterally over upper thighs corresponding to parallel abdominoplasty incision. 77 The mons pubis is then anchored to the abdominal fascia with permanent or delayed absorbable sutures. 53,[73][74][75]77 This procedure is commonly performed with an abdominoplasty or panniculectomy.…”

“…77 The mons pubis is then anchored to the abdominal fascia with permanent or delayed absorbable sutures. 53,[73][74][75]77 This procedure is commonly performed with an abdominoplasty or panniculectomy. If the mons pubis is not addressed at the time of abdominal contouring the patient may be left with an unsatisfactory aesthetic result.…”