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Biomechanical Properties of Skin in Massive Weight Loss Patients

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Abstract

Background

The aim of this study is to assess skin strength in MWL patients relative to control cosmetic abdominoplasty patients biophysically, biochemically, and histologically. Growing success of weight loss programs has brought about an increase in the MWL population. Skin quality is thought to be impaired by MWL, but there are no compelling studies that have fully addressed the structural mechanisms involved.

Methods

Skin from the medial and lateral abdomen was harvested fresh from patients undergoing cosmetic abdominoplasty (n = 6) or abdominal panniculectomy for MWL (n = 35), and burst strength was tested in the horizontal and vertical directions. Collagen content was measured, and histological studies were performed to assess epidermal and dermal thickness, vascularity as well as the morphology and density of the collagen fibers.

Results

In all groups, skin stretched horizontally was stronger than skin stretched vertically (p < 0.001). The skin of MWL patients was stronger medially compared to the skin of cosmetic patients. (p = 0.047) Newly formed collagen was diminished in MWL than that in the control group, but the results were not statistically significant. Epidermal thickness was significantly higher medially in MWL (p = 0.049). Elastin fibers were decreased in the MWL group, while dermal vascularity was higher in the MWL group.

Conclusions

The skin of MWL patients demonstrated stronger mechanical parameters than that of cosmetic patients in the medial part of the abdomen; however, the decrease in elastic fibers associated with a decrease in newly formed collagen seemingly provides a contradiction. Skin changes with MWL merits further study to understand it more completely.

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Authors and Affiliations

  1. The Johns Hopkins Medical Institutions, Division of Plastic Surgery, 4940 Eastern Ave, Baltimore, MD, 21224, USA

    Shelly Choo, Jessie Mallalieu & Michele A. Shermak

  2. Department of Surgery, Baltimore, MD, USA

    Guy Marti & Manuel Nastai

Authors
  1. Shelly Choo
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  2. Guy Marti
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  3. Manuel Nastai
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  4. Jessie Mallalieu
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  5. Michele A. Shermak
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Correspondence to Michele A. Shermak.

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Choo, S., Marti, G., Nastai, M. et al. Biomechanical Properties of Skin in Massive Weight Loss Patients. OBES SURG 20, 1422–1428 (2010). https://doi.org/10.1007/s11695-010-0147-6

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