Vulvar reconstruction using a mons pubis flap.

A mons pubis flap was used to reconstruct vulvar defects in 4 patients. This is an axial-pattern flap based on the superficial external pudendal vessels. Our cadaver injection studies demonstrated the vascular anatomy of the flap, which encompasses both a primary and a secondary vascular territory. Four patients were reconstructed, with excellent cosmetic results. The flap provides pliable, hair-bearing skin that resembles the normal vulva. The donor defect is inconspicuous and well hidden in the pubic hair. The flap is a reconstructive option for appropriate patients with full-thickness vulvar defects.