title: Monsplasty for women after massive weight loss.
abstract: BACKGROUND
  Ptosis with excess skin in the pubic area is a very common deformity in patients after massive weight loss. This deformity requires adequate surgical treatment whether combined with abdominoplasty or not. The enlarged pubogenital area may lead to psychosocial distress and impaired quality of life.
  
  
  METHODS
  A series of 23 women with a mean age of 39.5 years who previously underwent bariatric surgeries and later presented with pubogenital ptosis underwent monsplasty. The preoperative surgical markings and the surgical technique presented are easily reproducible. In this prospective study, the surgical outcomes were assessed by questionnaires applied to the patients, who scored the following parameters: movement dynamics, aesthetic appearance, sexual performance, improved hygiene, and use of clothing items.
  
  
  RESULTS
  Four of the parameters assessed (movement dynamics, aesthetic appearance, hygiene, and use of clothing items) showed clear improvement, with scores ranging from good to very good. A small percentage of the patients (13%) reported fair improvement in sexual performance.
  
  
  CONCLUSIONS
  The findings showed monsplasty to be a simple and reproducible technique with favorable outcomes and low morbidity rates.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.
authors.affiliation: Division of Plastic Surgery, University of Sao Paulo School of Medicine, Av. São Gabriel, 201, cj. 704/5, São Paulo, 01435-001, Brazil.
authors.forename: Maíra
authors.initials: M
authors.lastname: Marques
authors.forename: Miguel
authors.initials: M
authors.lastname: Modolin
authors.forename: Wilson
authors.initials: W
authors.lastname: Cintra
authors.forename: Rolf
authors.initials: R
authors.lastname: Gemperli
authors.forename: Marcus Castro
authors.initials: MC
authors.lastname: Ferreira
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005836:Genitalia, Female / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D015431:Weight Loss; D055815:Young Adult