FUPA Surgery: Mons Pubis Liposuction in Beverly Hills

What is FUPA surgery?

FUPA is slang for fullness of the mons pubis, the pad of fat and skin over the pubic bone, and FUPA surgery, also called FUPA removal or pubic liposuction, is liposuction of that pad. Dr. Cat numbs the mons with tumescent fluid, makes an incision a few millimeters long hidden in the pubic hair or the crease at the top of the thigh, and removes the excess fat evenly with a thin cannula. The aim is a mons that is flat and soft, in proportion to the lower belly, not one with no fat at all. If you are not sure whether what you have is fat or skin, start with our page on what a FUPA is and why it forms.

What it is not

Liposuction removes fat and only fat; it does not remove skin, tighten skin that has stretched, or release a cesarean scar. If the skin of the mons was stretched by pregnancy or a large weight loss, taking the fat out leaves the same skin with less inside it, and the mons can hang more. That problem has a different operation, the pubic lift (monsplasty): Dr. Cat lifts the tissue of the mons through a low horizontal incision, removes the excess skin and secures the deep tissue so it stays up. The lower belly above the mons needs its own liposuction or, for loose skin or separated abdominal muscles, a tummy tuck; our page on apron belly and loose skin after pregnancy explains the difference.

Who is a good candidate for FUPA surgery?

The best candidates have a mons that is full because of fat, skin that is still elastic, and a stable weight within about 20 pounds of their goal, because liposuction is contouring, not weight loss, and the mons follows your weight. Patients with a BMI of 30 or more, and patients who smoke, have a significantly higher risk of wound-healing problems; smokers must have stopped for two months to a year before surgery.

After pregnancy the usual finding is fat plus stretched skin, and the plan is liposuction with a pubic lift, very often as part of a tummy tuck that also repairs the muscle wall. After a large weight loss the skin is usually the main problem, and the plan is a lift, with liposuction only if fat remains.

FUPA liposuction vs a pubic lift

The pinch test at the consultation decides between the two: fat is thick and springy and keeps its shape when you lie down; stretched skin is thin, slides and folds under the fingers, and hangs lower standing than lying.

When Dr. Cat combines them

Most women who have had children have some of both; then the liposuction comes first, to thin the mons, and the lift follows in the same surgery. A lift done alone beside a loose abdomen leaves a step between the tight mons and the belly above it, so Dr. Cat usually performs the pubic lift with a tummy tuck, through the tummy tuck incision, or through the existing scar of patients who had a tummy tuck elsewhere.

How Dr. Cat does it

The mons is assessed at every body consultation

Dr. Cat is a board-certified plastic surgeon, trained in both head and neck surgery and plastic and reconstructive surgery, Harvard-educated and UCLA trained, and she treats liposuction as sculpture. She assesses the mons at every body consultation because she has seen too many patients who had an abdominoplasty elsewhere and were left with a tight, flat stomach and a mons hanging off the bottom of it. The front of the body is one contour: if the abdomen is being flattened and the mons carries fat, the mons is contoured in the same surgery, so there is no step, shelf or bulge at the incision line.

Tumescent and power-assisted liposuction, no heat devices

Dr. Cat uses tumescent liposuction: a saline solution with lidocaine and epinephrine is infused into the mons first, which numbs the tissue, constricts the blood vessels and limits blood loss. In most areas she uses power-assisted liposuction, a vibrating cannula that blends the treated area more evenly. Her multi-stage technique breaks the fat gently into tiny particles, removes it with thin cannulas precisely and evenly on a precise grid in which she counts every stroke, then blends a final time. She does not use laser lipo, SmartLipo, Vaser, J-Plasma, AirSculpt, Renuvion or other heat devices, because of the burns, uneven results and scar tissue they leave.

A thin cushion of fat, on purpose

A mons suctioned down to the bone looks hollow, feels hard and lets the skin stick to the tissue beneath; over-suctioning is where most of the bad liposuction Dr. Cat repairs comes from, and large, aggressive cannulas cause fibrosis and scar tissue. She uses thin cannulas and leaves a thin, even cushion of fat under the skin so the surface stays smooth and the mons stays soft. The fat pad cushions the pubic bone, and a completely flat mons is not the goal.

The pubic lift, when skin is part of the plan

When a pubic lift is part of the plan, Dr. Cat does the liposuction first, then makes a low curved incision where a tummy tuck incision sits, hidden under the underwear or bikini bottom she asks you to bring. The mons tissues are lifted and the deep tissues secured with sutures, never over-pulled and never so far that the pubic hairline sits too high, for a natural-looking contour and a thin, nearly invisible low scar without bunching, irregularities or step-offs.

Anesthesia and the surgery day

Surgery takes place in Dr. Cat's QUAD A accredited surgery center on Rodeo Drive. The mons on its own is a small area, and Dr. Cat treats small, isolated areas under local anesthesia with tumescent fluid, as awake liposuction, when it suits the plan; she advises at the consultation whether awake or general anesthesia fits you. With other areas, a pubic lift or a tummy tuck, it is done under general anesthesia with a board-certified physician anesthesiologist. Dr. Cat marks the mons while you stand, infiltrates it, makes the small incision and removes the fat, checking the contour by pinch and by eye so the mound is even and blends into the lower belly. A single small area takes about an hour and a half; a custom-measured compression garment goes on in the operating room, and after the mons alone you go home the same day with someone to stay with you.

Combining FUPA surgery with a tummy tuck

A tummy tuck removes the skin between the navel and the incision, which flattens the lower belly, but the mons below the incision stays where it was unless it is treated deliberately. Dr. Cat treats it in the same surgery: conservative liposuction of the mons for fat, about $3,500 added to the tummy tuck, a pubic lift through the tummy tuck incision for skin, or both, so the skin is uniformly tight from the ribs down. She does not perform aggressive or 360-degree liposuction in the same surgery, because the blood supply to the lifted abdominal skin travels through that fat; lipo 360 is staged on a separate day. Our comparison of a tummy tuck vs liposuction explains how she decides, and our liposuction page covers the mons as one area in a larger plan.

FUPA surgery recovery timeline

Recovery from liposuction of the mons is one of the easier liposuction recoveries, with one quirk: the mons is the most gravity-dependent part of the torso, so it swells more than other areas and looks puffier before it looks flatter.

• The day of surgeryYou are walking within a few hours and, after the mons alone, go home the same day with someone to stay with you. The mons feels sore and tight, like a deep bruise; most patients manage with Tylenol.
• The first weekMost patients return to desk work within a few days. Bruising can track downward with gravity and fades over two to three weeks. Swelling peaks, and the mons may look fuller than before surgery: that is fluid, not fat.
• Weeks two to sixSwelling settles from the top down. Walking is encouraged; running, cycling, lifting and anything that rubs the area wait until about four to six weeks. The garment is worn for six weeks, and there is no lymphatic massage, because none is needed. Numbness over the mons usually resolves over weeks to a few months.
• Six weeksThe garment comes off and full exercise resumes. Dr. Cat closes the incision meticulously and prescribes scar treatments so it fades to almost nothing.
• Three to six monthsThe final contour shows as the last of the swelling leaves. The fat cells removed do not come back; the cells that remain can grow with weight gain, so a stable weight keeps the result, and pregnancy can stretch the skin again.
• With a pubic liftMost patients feel almost back to normal at about one week, with activity restrictions for four to six weeks and a measured compression garment for six to eight weeks; a drain, when skin is removed, comes out within the first few days. The mons feels tight but should not be painful, and the scar fades over about a year.
• With a tummy tuckThe timeline is the tummy tuck's: the first night in a plastic surgery aftercare center, desk work at about two weeks and full exercise at six, and the mons follows it. See our tummy tuck recovery guide, week by week.

Risks and safety

Liposuction of the mons is low-risk in experienced hands, and it is still surgery. Dr. Cat reviews the risks with every patient before surgery, and tracks the anesthetic and the volume removed throughout.

How much does FUPA surgery cost in Beverly Hills?

Dr. Cat's surgeon's fee for mons pubis liposuction is about $6,500 to $7,500; your written quote adds anesthesia and the facility. That is the per-area fee when the mons is one of several liposuction areas in one surgery; like any single area on its own, the mons alone is a $10,000 surgeon's fee, and added to a tummy tuck it is about $3,500. A pubic lift is quoted at your consultation, according to how much skin is removed. Every quote is itemized, surgeon's fee, anesthesiologist, facility, first compression garment and follow-up visits, so there are no surprises later.

The price reflects who is holding the cannula: one surgeon who performs every pass herself, a physician anesthesiologist for general anesthesia, and an accredited facility. Published national averages for liposuction run from about $6,380 to $15,000, figures that leave out much of what a quote contains. Our liposuction cost guide prices every area.

Consultation fee and financing

The consultation with Dr. Cat is $500, or $1,500 for a revision, credited in full toward your surgery; out-of-town patients start with a private video consultation through OnPatient, the HIPAA-secure patient portal. To pay over time, the practice partners with Cherry, its primary financing partner, and also accepts CareCredit and Alphaeon Credit; see financing and payment plans. Liposuction of the mons and a pubic lift are cosmetic procedures and are not covered by insurance.

Your consultation with Dr. Cat

It starts with a free 15-minute discovery call with our Patient Concierge, who books your consultation. At the consultation, in person on Rodeo Drive or by video with photos through OnPatient for out-of-town patients, Dr. Cat examines the mons standing and lying down, pinches it to judge fat against skin, looks at the lower abdomen and any cesarean or tummy tuck scar, and reviews your health, medications and weight history. You leave knowing which operation you need, whether it should be done awake or under general anesthesia, and with an itemized written quote.