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

Rocha, Robson S.; Junior, Wilson Cintra; Modolin, Miguel; Takahashi, Giulia Godoy; Caldini, Élia Garcia; Gemperli, Rolf

doi:10.1007/s11695-020-05100-3

Cited by 6 publications

(3 citation statements)

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“…However, they observed significant structural changes in the dermis, notably a reduction in thick, well-structured collagen fibers and an increase in loosely arranged, thin collagen fibers in SMWL patients. Additionally, there was an increase in elastic fibers in SMWL patients compared to patients with obesity (1.3% vs 0.8%, respectively) [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…High incidences of BCS have been observed in patients following BMS, with reported rates varying from 6 to 21%. Among these procedures, abdominoplasty is the most performed, followed by mastopexy [ 4 – 7 ]. Furthermore, patients who undergo BCS following BMS are reported to have a higher risk of developing complications compared to other patients [ 8 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Rapid and substantial MWL post-BMS often results in changes in these critical skin components. These changes compromise the skin’s ability to retract and conform to the body’s new contours, thereby elevating the risk of suboptimal early and late outcomes in BCS [ 3 , 7 ]. Nevertheless, few studies have specifically addressed the changes in skin structure associated with significant MWL.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Histological Skin Changes After Massive Weight Loss in Post-bariatric and Non-bariatric Patients

Hany,

Zidan,

Ghozlan

et al. 2024

OBES SURG

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Background Changes in the skin structure, including the collagen and elastin content, have been reported with massive weight loss (MWL) following bariatric metabolic surgery (BMS) and have been correlated to a higher risk of complications after body-contouring surgery (BCS). This study aimed at comparing the histological characteristics of the skin of patients having surgical MWL (SMWL) post-BMS to those with non-surgical massive weight loss (NSMWL). Methods This prospective study compared the epidermal thickness, and collagen and elastin fibers content in 80 skin biopsies obtained from BCS procedures performed to patients who experienced MWL defined more than 50% of excess weight loss (%EWL) either SMWL (40 biopsies) or NSMWL (40 biopsies). Twenty biopsies in each group were obtained from abdominoplasties and 20 from breast reductions. Epidermal thickness was measured in H&E-stained sections, collagen fibers were assessed using Masson trichrome-stained sections, and elastin fibers were assessed using Modified Verhoeff’s stained sections. Image analysis software was used to calculate the fractions of collagen and elastin fibers. Results This study included 77 patients, 38 SMWL patients, and 39 NSMWL patients. The SMWL group had a significantly higher age (p < 0.001), a longer time interval from intervention (p < 0.001), higher initial weight (p < 0.001), higher initial BMI (p < 0.001), lower current weight (p = 0.005), lower current BMI (p < 0.001), and significantly higher %EWL than NSMWL group (p < 0.001). No significant differences were detected between the two groups regarding complications after abdominoplasty (p = 1.000). The elastic fibers content in the dermis was significantly higher in the abdominal region of the NSMWL group than SMWL (p = 0.029). All other parameters showed non-significant differences between NSMWL and SMWL in the skin of abdomen and breast. Conclusion The SMWL group had a significant reduction in elastic fiber content in the skin of the abdomen compared to the NSMWL group. The collagen content was equally reduced in both groups with non-significant differences in both breast and abdomen regions in both groups. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%