Restoration of the mons pubis during abdominoplasty and belt lipectomy is an important part of aesthetic outcome in body contouring. A challenge is how to redistribute the excess tissue of the abdominal flap when closing the incision. Often, the closure is started laterally to minimize dog-ear deformity, but as a result, excess tissue is bunched up toward the midline, distorting the appearance of the subunit mons pubis. To our knowledge, the normal dimensions and angles of the mons have not been defined, and only limited data are available describing the mons as a separate subunit and treating it as such during abdominoplasty and belt-lipectomy.1
Our goal is to define specific measurements of the mons pubis in normal weight females, respect the mons as a separate aesthetic subunit, and be able to apply these lines and angles during abdominoplasty and belt lipectomy to each individual patient.
Our study design involves evaluating 28 female mons pubis measurements. Healthy female volunteers aged 26 to 53 years (mean, 35 ± 8.4 years) with a body mass index between 18 and 26 (mean, 21 ± 2.4) and no prior altering operations in the mons area were evaluated. In addition, measurements of 13 female cadavers aged 60 to 95 years (mean, 82 ± 9.5 years) were performed. The following lines and angles were measured: 1) umbilicus to pubic hairline/skin fold = top of mons pubis; 2) top of the mons pubis to the end of the labia majora (height of triangle = a = a1 + a2); a1) top of the mons pubis to the cleft; a2) length of the labia majora (cleft to end of labia); 3) lengths of the side segment lines (end of the labia majora along the inguinal crease up to the lateral hairline at the femoral vessels = b); 4) lengths of base of mons triangle = c; 5) inguinal crease/pubic hairline angle = α°; 6) inguinal crease/labia majora angle (tip of mons triangle = β°) (Fig. 1). The mean, median, and SD values were calculated for each measurement.
The average measurements of the 28 female subjects are summarized in Table 1. The measurements of the mons pubis dimensions are dependent on body size/weight and age. There seems to be a slight enlargement of all mons dimensions, with a slight drop in acuity of the triangle in the significantly older cadaver group. However, the sample size is too small for us to draw any conclusions about significance of subgroup variations.
Defining the normal dimensions and angles of the mons pubis makes it possible to apply those measurements during abdominoplasty and belt lipectomy. Abdominal skin flap closure is often started laterally to minimize dog-ear deformity but thereby bunching excess tissue into the subunit mons. We therefore start the abdominal skin flap closure in the midline, followed by securing the mons corners, creating the mons triangle with the ideal angles, avoiding bunching of redundant skin medially into the aesthetic subunit of the mons pubis. We propose that by applying these dimensions, our patients will have a more pleasing appearance of the mons area and potentially greater satisfaction with the aesthetic outcome of their body contouring procedure.
The authors have no financial interest to disclose in relation to the content of this article.
Iris A. Seitz, M.D., Ph.D.
Cindy Wu, M.D.
Kelly Retzlaff, A.P.N.
Lawrence Zachary, M.D.
Section of Plastic and Reconstructive Surgery
University of Chicago Medical Center
1. Matarasso A, Wallach SG. Abdominal contour surgery: Treating all aesthetic units, including the mons. Aesthetic J Surg
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