Excess skin problems among adolescents after bariatric surgery

Area of Science:

• Adolescent health
• Surgical outcomes
• Dermatology

Background:

• Bariatric surgery offers significant weight loss for severely obese adolescents.
• Excess skin and soft tissue are common adverse consequences of massive weight loss.
• While adults have been studied, adolescent excess skin complications post-bariatric surgery are not well-described.

Purpose of the Study:

• To describe the natural history of excess skin and its complications in severely obese adolescents after bariatric surgery.
• To investigate the prevalence and characteristics of excess skin-related symptoms in this population.

Main Methods:

• Prospective, multi-institutional study of adolescents (13-19 years) undergoing bariatric surgery.
• Evaluation of abdominal pannus severity (graded 0-5) and excess skin symptoms preoperatively and for 5 years post-surgery.
• Data sourced from the Teen-Longitudinal Assessment of Bariatric Surgery cohort.

Main Results:

• 90% of 217 participants had an abdominal pannus; 7% reported symptoms pre-surgery (infections, cellulitis, ulcerations).
• Higher preoperative pannus grade correlated with greater pannus severity reduction and increased postoperative symptoms.
• Pannus severity changes occurred within 24 months, stabilizing thereafter.

Conclusions:

• Severely obese adolescents frequently have symptomatic abdominal pannus at bariatric surgery.
• A higher preoperative pannus grade predicts more post-surgical pannus-related symptoms.
• Counseling regarding potential body contouring surgery is recommended for this patient group.