Skin Changes Due to Massive Weight Loss: Histological Changes and the Causes of the Limited Results of Contouring Surgeries

Skin Changes Due to Massive Weight Loss: Histological Changes and the Causes of the Limited Results of Contouring Surgeries

Purpose Outcomes of body contouring surgeries in patients who previously had obesity are limited because of the loss of skin quality. This study aimed to evaluate the morphometric characteristics of collagen and elastic fibers of the skin in the abdominal epigastric region of patients who had massiv...

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Bibliographic Details
Published in:Obesity surgery Vol. 31; no. 4; pp. 1505 - 1513
Main Authors: Rocha, Rodrigo I., Junior, Wilson Cintra, Modolin, Miguel L. A., Takahashi, Giulia G., Caldini, Elia T. E. G., Gemperli, Rolf
Format: Journal Article
Language:English
Published: New York Springer US 01-04-2021
Springer Nature B.V
Subjects:
Bariatric Surgery
Body Contouring
Collagen
Gastrointestinal surgery
Humans
Medicine
Medicine & Public Health
Obesity
Obesity, Morbid - surgery
Original Contributions
Skin
Surgery
Weight control
Weight Loss
Obesity
Collagen
Elastin
Skin changes
Weight loss
Skin
Histology
Body contouring surgeries
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Summary:Purpose Outcomes of body contouring surgeries in patients who previously had obesity are limited because of the loss of skin quality. This study aimed to evaluate the morphometric characteristics of collagen and elastic fibers of the skin in the abdominal epigastric region of patients who had massive weight loss following bariatric surgery and compared such with the skin characteristics of patients with morbid obesity. Methods This observational study compared skin fragments from the epigastric region of 20 patients who had massive weight loss due to bariatric surgery and 20 patients with morbid obesity. The morphometric analysis was performed on the collagen system using the Picrosirius/polarized light method and on the elastic system using the Weigert’s resorcin-fuchsin method. Results Reduction of thick collagen fibers ( p  = 0.048), increased thin collagen fibers ( p  = 0.0085), and increased elastic fiber density ( p  < 0.001) were observed in the massive weight loss group. No differences were found between the groups regarding mean age ( p  = 0.917) and total amount of collagen fibers ( p  = 0.3619). Structural dermis alterations in the massive weight loss group demonstrated collagenous remodeling, with consequent reduction of thick, organized, structured, and directed fibers in favor of thin, misaligned, and loosely arranged fibers. Weight loss was also associated with increased skin elasticity. Conclusion The morphometric changes in the collagen and elastic system scientifically explained the already established clinical perception of cutaneous alterations in patients who had massive weight loss following bariatric surgeries.
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ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-020-05100-3