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What Is FUPA?

Medically Reviewed by Jabeen Begum, MD on November 11, 2022

Weight gain and obesity can lead to a number of different problems in terms of both your physical health and your overall body image. One issue that you may find yourself worrying about — even after you’ve lost weight — is called FUPA. The acronym FUPA stands for “fatty upper pubic area.” 

In some instances, FUPA can both cause physical problems and negatively impact your self-esteem. If this is a real problem for you, then there are surgical and psychological treatments that can help.

What Causes FUPA?

When you gain weight, fat can accumulate all over your body. This includes the region above your pubic area — technically called the mons pubis. It’s a prominent cushion that protects your pubic bones and produces your pubic hairs. 

In females with FUPA, the tissue on both sides of your vulva — called the labia major — also becomes fatty and can distort the appearance of your genital region. In males, excessive weight gain can lead to a problem that’s referred to as a buried penis

When caused by obesity, this condition refers to the way that the tissues surrounding the penis are so large that they hide your otherwise-normal genitals. A buried penis could also be the result of other problems — like abnormal ligaments that are present at birth. Only weight-related versions of this problem are discussed here. 

Even once you’ve lost weight, FUPA-related problems can persist, and new ones could develop. If you’re obese — particularly in the category of type III obesity, or morbid obesity — losing large amounts of weight is great for your health. Unfortunately, it doesn’t always produce the type of body that you want. 

Even after plenty of weight loss, the fat above your pubic area is likely to remain intact. Plus, losing anywhere in excess of 100 pounds — an impressive accomplishment — often results in a lot of extra skin. This skin can hang down and cover your pubic region and upper thighs. This condition is called panniculus, and the flap of skin is called a pannus.

All of these problems are broadly related to the concept of FUPA. These issues both have similar symptoms and comparable treatment solutions.

What Are the Symptoms of FUPA? 

The exact symptoms of fat- and skin-based excesses in the genital region vary from person to person. They depend on factors like your sex, size, and body type. 

All of these conditions can create serious psychological side effects, including low self-esteem. You could also find yourself avoiding situations, outfits, and other aspects of life that you would otherwise enjoy. 

Physically, it’s easier to develop infections in moist areas with lots of fat folds. Repeated infections in your genital region aren’t good for your overall health. Even if you keep the area clean, you could still get rashes and sores where your skin rubs against itself. 

There are additional physical symptoms that can accompany panniculus in particular. These include: 

  • Difficulty cleaning the entire area of skin
  • Problems walking — when the skin interferes with your stride
  • Problems with other daily activities — like ones that involve bending over
  • Difficulty finding clothing that fits properly, since none are specifically designed with this particular excess in mind

Symptoms specific to a buried penis include: 

  • Difficulty peeing when standing up
  • Frequent urinary tract infections
  • Difficulty getting an erection or pain when you do get an erection
  • Problems penetrating your partner

What’s the Best FUPA Treatment?

You and your doctor will need to work together to decide on the treatment option that’s best for you. Have your doctor or plastic surgeon clearly explain the outcomes and ramifications of each option in the context of your unique body. 

If the symptoms are more psychological than physical, you could benefit from talking to a therapist. People of all ages, shapes, and sizes have a tendency to worry about their physical appearance. Many people have at least a feature or two that they wish was just a bit different. Talking to a therapist can help you decide whether or not you’re seeking surgery for healthy reasons. 

Otherwise, there are many different types of surgeries available for FUPA-related issues. They include:

  • Pubic liposuction. This is a way to remove the fat just from your mons pubis. It’s useful when your skin is elastic enough to stretch back after the fat is removed. Otherwise, it may leave sags in the area. The surgeon makes small incisions, normally near the creases of your groin, and removes the fat through these. The surgery leaves little scarring behind. In females, the surgeon also removes fat from the labia major. 
  • Pubic lifts. This is a more common surgery than liposuction alone because it involves lifting your pubic skin along with fat removal. To lift your skin, the surgeon cuts a long, horizontal line across your pubic region and then moves up and tightens this skin. This leaves a large scar that some people don’t like. In many cases, your pubic area will eventually slide back down, but doctor don't recommend second lifts. For the best results, the flap of skin should be attached to the muscle underneath, which will slow or prevent a descent.   
  • Panniculectomy. This is a surgery specifically designed to remove the flap of skin that’s left after you lose a lot of weight. Depending on the surgeon, the cuts could extend from underneath your breast bone to the top of your pubic bone and across the width of your stomach just above the pubic region. The surgeon removes the skin and any remaining fat within it. They then close up your remaining skin with stitches. This will leave large, visible scars that could take years to fully heal.   
  • Abdominoplasty. This surgery is commonly called a tummy tuck. It focuses more on your abdominal region but is commonly done at the same time as a panniculectomy, pubic lift, or regional liposuction. This surgery removes excess fat and tightens your abdominal muscles so they don’t protrude as far from your frame. There are a variety of ways to perform this surgery, but all methods are likely to create scars. 

Other, related methods are available. Find a plastic surgeon that you trust to discuss the latest options. Then you can decide on the surgery — or combination of surgeries — that’s right for you.

What Does Post-Surgery Recovery Look Like? 

You should keep the recovery details in mind when choosing the surgery that’s best for your needs. Small-scale surgeries — like pubic liposuction — will have faster recoveries and less long-term scarring than more in-depth surgeries.

For example, if you undergo a panniculectomy, you’ll likely need to take time off from work during the recovery period. You’ll also need to limit physical activity for a number of weeks and wear a special girdle-type device while your body heals. There can be a lot of swelling and inflammation during your recovery period. It could take up to two years for your post-surgery appearance to stabilize. 

Talk to your doctor about these options so you can properly prepare for your recovery process.

What's the Prognosis for FUPA Surgeries?

Most people who opt to have these surgeries are pleased with the results. Just make sure to carefully consider your options beforehand, and be aware of the limitations and recovery times associated with each type of surgery. After going through the hard work of weight loss, you deserve a treatment that will truly benefit your body.

Show Sources

SOURCES: 
Cleveland Clinic: “Buried Penis,” “Class III Obesity (Formerly Known as Morbid Obesity).” 
Johns Hopkins All Children’s Hospital: “Plastic Surgery.” 
Sex in the 21st Century: “Enlarged Mons Pubis (Excessive Pubic Fat).” 
UCSF Health: “Panniculectomy.”

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