Collagen and elastic content of abdominal skin after surgical weight loss.
BACKGROUND
Collapsed skin folds after bariatric weight loss are often managed by plastic procedures, but changes in dermal composition and architecture have rarely been documented. Given the potential consequences on surgical outcome, a prospective histochemical study was designed. The hypothesis was that a deranged dermal fiber pattern would accompany major changes in adipose tissue.


METHODS
Female surgical candidates undergoing postbariatric abdominoplasty (n=40) and never obese women submitted to control procedures (n=40) were submitted to double abdominal biopsy, respectively in the epigastrium and hypogastrium. Histomorphometric assessment of collagen and elastic fibers was executed by the Image Analyzer System (Kontron Electronic 300, Zeiss, Germany).


RESULTS
Depletion of collagen, but not of elastic fibers, in cases with massive weight loss was confirmed. Changes were somewhat more severe in epigastrium (P=0.001) than hypogastrium (P=0.007). Correlation with age did not occur.


CONCLUSIONS
(1) Patients displayed lax, soft skin lacking sufficient collagen fiber network. (2) Elastic fiber content was not damaged, and was even moderately increased in epigastrium; (3) Preoperative obesity negatively correlated with hypogastric collagen concentration; (4) Future studies should pinpoint the roles of obesity, and especially of massive weight loss, on dermal architecture and response to surgery.
Orpheu
Simone C
SC
Division of Plastic Surgery, Hospital das Clinicas, Sao Paulo University Faculty of Medicine, Sao Paulo, Brazil. simoneorpheu@terra.com.br
Coltro
Pedro S
PS
Scopel
G P
GP
Gomez
D S
DS
Rodrigues
C J
CJ
Modolin
Miguel L A
ML
Faintuch
Joel
J
Gemperli
Rolf
R
Ferreira
Marcos C
MC
D034861:Abdominal Wall / Q000473:pathology*; D000328:Adult; D003094:Collagen / Q000032:analysis*; D004547:Elastic Tissue / Q000378:metabolism*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology* / Q000601:surgery*; D011446:Prospective Studies; D012867:Skin / Q000737:chemistry / Q000503:physiopathology*; D015431:Weight Loss
D003094:Collagen