Goals/Purpose:
Post-gastric bypass and diet-induced weightloss patients present for body contouring. Gross differences in dermal elasticity exist between these populations, yet studies evaluating histologic differences are lacking. This prospective study evaluates histological differences in morbidly obese patients following surgical (Roux-en-Y gastric bypass) versus diet-induced (nonsurgical) weight loss, examining if mechanism of weight loss imparts histologic changes that translate to wound complications.
Methods/Technique:
Following IRB approval, infraumbilical panniculus was collected from abdominal contouring procedures following weight loss (≥ 20 lbs) achieved through surgical or nonsurgical means. Specimens were stained for elastic fiber content and morphology, collagen deposition, and inflammation. Sections were evaluated by a dermatopathologist in the context of age-matched controls. Histomorphological results were compared between the two groups and analyzed according to clinical variables and wound complications.
Results/Complications:
Thirty consecutive weightloss patients (17 surgical, 13 nonsurgical) presented for panniculectomy (n=15 patients), abdominoplasty (n=13), and lower body lift (n=2) with average age of 48.3±11.10 years and BMI of 39.23±13.65 kg/m2. Demographic and clinicopathologic variables were not statistically significant between the groups. Blinded histologic evaluation revealed a trend toward normal elastic fiber appearance (p=0.255) and mild inflammation (p=0.462) in the surgical group (Table 1, Figure). Analysis of dermal histomorphology versus wound complications was not statistically significant at followup (4.76±5.55 months) (Table 2).
Conclusion:
Although data did not reach statistical significance, mechanism of weight loss may impact dermal morphology. Our data does not support a relationship between dermal morphology and postoperative wound complications, suggesting that aberrant healing in body contouring procedures is multifactorial. Further studies may help to elucidate this relationship.
