Todurov I. M., Plehutsa O. I., Strukov Y. S.

PUBIC REGION PLASTY (MONSPLASTY) AS A STAGED BODY-CONTOURING PROCEDURE AFTER WEIGHT LOSS IN PATIENTS WITH OBESITY AND CONCOMITANT METABOLIC SYNDROME

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Todurov I. M., Plehutsa O. I., Strukov Y. S.

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CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

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The paper presents a clinical case of surgical correction of mons pubis deformity in a patient with obesity after significant conservative weight loss and concomitant metabolic syndrome. The subject of the study is the evaluation of the clinical feasibility and safety of performing monsplasty using a combined vertical-horizontal H-shaped technique as a primary stage of reconstructive body contouring of the lower trunk. The aim of the study is to demonstrate the possibilities of monsplasty as a staged procedure in patients after massive weight loss (MWL) to eliminate the most clinically significant deformity of the mons pubis, reduce mechanical and hygienic limitations, improve quality of life, and create conditions for further planned correction of the anterior abdominal wall (abdominoplasty) after stabilization of body weight and metabolic status. The study is based on clinical observation and a detailed description of a case involving a 48-year-old patient with grade III obesity and concomitant metabolic disorders, who, after significant conservative weight loss, developed pronounced ptosis of the skin and subcutaneous tissue of the mons pubis region, causing mechanical, hygienic, and psychoemotional discomfort. Prior to surgery, a comprehensive set of clinical, laboratory, and instrumental examinations was performed to assess metabolic status, identify and verify comorbidities, and stratify perioperative risks. Preoperative marking was also performed. Surgical treatment consisted of monsplasty using a combined vertical-horizontal H-shaped approach as the first stage of reconstructive body contouring of the lower trunk, followed by dynamic postoperative monitoring and evaluation of early outcomes, with planning of subsequent stages of correction (abdominoplasty) after stabilization of body weight and metabolic status. The early postoperative period after monsplasty had a controlled course: the patient’s general condition remained stable, routine dressings were performed, and dynamic monitoring of the postoperative wound was carried out. In the early period after surgery, a reduction in mechanical and hygienic discomfort associated with mons pubis ptosis was observed, along with improved mobility and self-care conditions. The obtained result ensured the formation of a more harmonious lower trunk contour and created conditions for further staged reconstructive procedures (in particular, planned abdominoplasty) after stabilization of body weight and metabolic status. The results of this clinical observation emphasize the importance of including the assessment of mons pubis deformities in standard preoperative planning of body contouring surgery in patients after massive weight loss, especially in the presence of obesity and metabolic disorders. The described approach demonstrates that monsplasty can be considered a justified primary stage of reconstructive body contouring of the lower trunk aimed at reducing mechanical and hygienic discomfort, improving quality of life, and creating conditions for further surgical interventions (in particular, abdominoplasty) after stabilization of body weight and metabolic status. These findings may be useful for plastic surgeons, bariatric specialists, endocrinologists, and multidisciplinary teams in developing algorithms for patient selection, preoperative preparation, and staged management of patients after MWL. The presented clinical case demonstrates that in patients after significant weight loss, multizonal body contour deformities may require a staged reconstructive approach, and mons pubis deformity is often a leading source of functional and psychoemotional discomfort. Performing monsplasty as an initial stage allows elimination of the most clinically significant deformity, improvement of mobility and hygienic comfort, formation of a more harmonious lower trunk contour, and ensuring a predictable postoperative course. The findings highlight the importance of preoperative assessment and optimization of metabolic status, as well as a multidisciplinary approach in planning further stages of correction (in particular, abdominoplasty) after stabilization of body weight.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 2, 181, 188-198 pages, index UDC 616-089.844:616.718-089:616-056.257

DOI:

10.29254/2077-4214-2026-2-181-188-198