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Collagen and Elastic Content of Abdominal Skin After Surgical Weight Loss

  • Clinical Research
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Abstract

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.

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References

  1. Enser M, Avery NC. Mechanical and chemical properties of the skin and its collagen from lean and obese hyperglycaemic (ob/ob) mice. Diabetologia. 1984;27:44–9.

    Article  CAS  PubMed  Google Scholar 

  2. Ishikawa T, Ishikawa O, Miyachi Y. Measurement of skin elastic properties with a new suction device (1): relationship to age, sex and the degree of obesity in normal individuals. J Dermatol. 1995;22:713–7.

    CAS  PubMed  Google Scholar 

  3. Yosipovitch G, Deore A, Dawn A. Obesity and the skin: skin physiology and skin manifestations of obesity. J Amer Acad Dermatol. 2007;56:901–16.

    Article  Google Scholar 

  4. Ishida RK, Faintuch J, Kuga R, et al. Microbial flora of the stomach after gastric bypass for morbid obesity. Obes Surg. 2007;17:752–8.

    Article  PubMed  Google Scholar 

  5. Cintra W Jr, Modolin ML, Gemperli R, et al. Quality of life after abdominoplasty in women after bariatric surgery. Obes Surg. 2008;18:728–32.

    Article  PubMed  Google Scholar 

  6. Koehler MJ, Hahn S, Preller A, et al. Morphological skin ageing criteria by multiphoton laser scanning tomography: non-invasive in vivo scoring of the dermal fibre network. Exp Dermatol. 2008;17:519–23.

    Article  PubMed  Google Scholar 

  7. Samuel CS, Zhao C, Bathgate RA, et al. The relaxin gene-knockout mouse: a model of progressive fibrosis. Ann NY Acad Sci. 2005;1041:173–81.

    Article  CAS  PubMed  Google Scholar 

  8. Cooney TE, Schober JM, Lubahn JD, et al. Relaxin involvement in extracellular matric homeostasis. Ann N Y Acad Sci. 2009;1160:329–35.

    Article  CAS  PubMed  Google Scholar 

  9. Watson REB, Parry EJ, Humphries JD, et al. Fibrillin microfibrils are reduced in skin exhibiting striae distensae. Br J Dermatol. 1998;138:931–7.

    Article  CAS  PubMed  Google Scholar 

  10. Rasmussen MH, Jensen LT, Andersen T, et al. Collagen metabolism in obesity: the effect of weight loss. Int J Obes Relat Metab Disord. 1995;19:659–63.

    CAS  PubMed  Google Scholar 

  11. Derosa G, Ferrai I, D'Angelo A, et al. Matrix metalloproteinase-2 and -9 levels in obese patients. Endothelium. 2008;15:219–24.

    Article  CAS  PubMed  Google Scholar 

  12. Blüher M. Adipose tissue dysfunction in obesity. Exp Clin Endocrinol Diabetes. 2009;117(6):241–50.

    Article  PubMed  Google Scholar 

  13. Callaghan TM, Wilhelm KP. A review of ageing and an examination of clinical methods in the assessment of ageing skin. Part I: cellular and molecular perspectives of skin ageing. Int J Cosmet Sci. 2008;30:313–22.

    Article  CAS  PubMed  Google Scholar 

  14. Migliori FC, Robello G, Ravetti JL, et al. Histological alterations following bariatric study: pilot study. Obes Surg. 2008;18:1305–7.

    Article  PubMed  Google Scholar 

  15. Kulaylat MN, Karakousis CP. Large gaps of midline abdominal incisions and their management. Am Surg. 2008;74:1094–9.

    PubMed  Google Scholar 

  16. White B, Osier C, Gletsu N, et al. Abnormal primary tissue collagen composition in the skin of recurrent incisional hernia patients. Am Surg. 2007;73:1254–8.

    PubMed  Google Scholar 

  17. Rosch R, Junge K, Knops M, et al. Analysis of collagen-interacting proteins in patients with incisional hernias. Langenbecks Arch Surg. 2003;387:427–32.

    CAS  PubMed  Google Scholar 

  18. Bing C, Russell S, Becket E, et al. Adipose atrophy in cancer cachexia: morphologic and molecular analysis of adipose tissue in tumour bearing mice. Br J Cancer. 2006;95:1028–37.

    Article  CAS  PubMed  Google Scholar 

  19. Goodson MH III, Hunt TK. Wound collagen accumulation in obese hyperglycemic mice. Diabetes. 1986;35:491–5.

    Article  CAS  PubMed  Google Scholar 

  20. Leong PL. Aging changes in the male face. Facial Plast Surg Clin North Am. 2008;16:277–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors disclose no commercial involvement or conflict of interest. The help of CNPq Grant 300392/2008-7 is appreciated.

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Authors and Affiliations

  1. Division of Plastic Surgery, Hospital das Clinicas, Sao Paulo University Faculty of Medicine, Sao Paulo, Brazil

    Simone C. Orpheu, Pedro S. Coltro, G. P. Scopel, D. S. Gomez, Miguel L. A. Modolin, Rolf Gemperli & Marcos C. Ferreira

  2. Department of Anatomy, Sao Paulo University Faculty of Medicine, Sao Paulo, Brazil

    C. J. Rodrigues

  3. Nutrology Group, Hospital das Clinicas, Sao Paulo, Brazil

    Joel Faintuch

Authors
  1. Simone C. Orpheu
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  2. Pedro S. Coltro
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  3. G. P. Scopel
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  4. D. S. Gomez
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  5. C. J. Rodrigues
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  6. Miguel L. A. Modolin
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  7. Joel Faintuch
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  8. Rolf Gemperli
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  9. Marcos C. Ferreira
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Correspondence to Simone C. Orpheu.

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Orpheu, S.C., Coltro, P.S., Scopel, G.P. et al. Collagen and Elastic Content of Abdominal Skin After Surgical Weight Loss. OBES SURG 20, 480–486 (2010). https://doi.org/10.1007/s11695-009-0019-0

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  • DOI: https://doi.org/10.1007/s11695-009-0019-0

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