Monsplasty after massive weight loss: Assessment of its aesthetic and functional impact

Massive weight loss frequently leads to a ptosis or a pubic bulge. This deformation is a source of functional as well as aesthetic discomfort, and it also has psychological repercussions. We have analyzed the degree of satisfaction reported by 23 female patients having undergone a monsplasty procedure and have also proposed a decisional algorithm designed to facilitate surgical care according to type of pubic deformation.

This is a one-year prospective study involving 23 female patients having undergone a monsplasty procedure following massive weight loss. The interventions were all carried out in standardized fashion by the same surgeon according to stage of deformation. Analysis of the patients' degree of aesthetic and functional satisfaction was performed using a questionnaire filled out during preoperative and postoperative consultations, the latter taking place 6 months to one year after the operation. It included a self-esteem assessment based on the Rosenberg scale, appraisal of functional benefits (clothing, sexual activity, daily physical activities, intimate hygiene) and evaluation of the pubis in aesthetic terms.

Assessment of impact on self-esteem revealed average improvement of 10.08 points, rising from 25.87 to 35.95. All of the patients, without exception, were satisfied or very satisfied with the impact of monsplasty on the different items under evaluation. stage 3 and stage 4 patients were particularly sensitive to improvement involving personal hygiene, physical activities and the clothes they wore. In most cases, they likewise reported a positive impact on their sexual experience.

Abdominoplasty or body lift without monsplasty can entail long-lasting aesthetic and functional discomfort. Thorough preoperative semiological analysis is essential to optimized surgical care conducive to successful integration of the monsplasty. An appropriate caretaking attitude enhances both the aesthetic result and patient self-esteem.