Weight-Loss Surgery
You can know the name of a bird in every language in the world, but when you're done, you'll know nothing about the bird whatsoever.... So let's examine the creature and determine what it is.
doing so is what matters. I learned very early on the distinction between knowing something and knowing its name.
Richard Feynman, the physicist, stated:
It appears that after weight-loss surgery, the organ most people take for granted is the source of the most concern. That is the epidermis. This chapter is dedicated to helping you better understand this organ, which is so uniquely affected by weight gain and loss, so that you can care for it more effectively.
Gross anatomy is the first course that medical students attend. This is the study of all body parts, no matter how large or microscopic. Anatomy is the study of how all the body's organs, blood vessels, nerves, and bones join together in a neat package. Often neglected is the fact that the package is encased in a single remarkable organ that we call skin.
The skin is not only the largest organ in the body, but also one of the most essential. We take the epidermis for granted, perhaps because we see and touch it so frequently. With the exception of the eyes, all other organs are concealed and therefore appear to be more enigmatic and significant.
Recently, an art exhibit entitled "Body Worlds" visited our metropolis. Perhaps you've seen it. The exhibition features a collection of anatomical dissections, some of individual organs and several skinless human bodies in various poses. The underlying muscles, bones, and organs are presented in a captivating and artistic manner for all to see.
Clearly, the dissection of these bodies occurred after death, and the tissues have been preserved to prevent decomposition. Because these are parts of real bodies that the majority of people have never seen, the exhibit elicits a spectrum of emotions, from awe to disgust. Constantly, they are clothed in ordinary, aged skin. By depicting these dissected specimens performing various activities, such as playing basketball or mounting a horse, the artist is attempting to demonstrate what a living body would look like if its exterior were removed. In actuality, however, human existence is impossible without the protection provided by the skin.
What Is Skin and What Is Its Function?
The epidermis is a highly complex organ with numerous vital functions. It is both flexible and incredibly durable. It is impervious to water and entirely washable, but requires very little maintenance. It is one of our most essential sensory organs, allowing us to experience both pleasurable touch and painful sensations that can trigger a reflexive withdrawal from danger. It provides the most essential mechanism for regulating our body temperature and serves as our primary defense against bacterial invasion. It continually replaces itself and is capable of regenerating itself automatically when injured.
It develops alongside us from infancy to maturity. It can expand to satisfy the needs of a growing body, as we have all witnessed with obesity or pregnancy, and then return to its original size. It can survive and thrive when transferred from one part of the body to another, or even from one body to another. It can be neglected and even abused, as we frequently do, but it continues to serve us in all of these ways. The skin is undoubtedly one of the body's most remarkable organs.
The skin consists of two primary layers. The epidermis is the top or superficial layer, which is perpetually replaced. The second or deeper layer, the dermis, is relatively stable.
The layer of cells that separates these two layers is known as the basal layer, and it is responsible for creating the epidermis by perpetually producing new cells that are pushed toward the surface. As cells approach the surface, they tend to flatten and perish. The surface of the skin is comprised of layers of dead cells that inevitably deteriorate and are replaced by new cells making their way to the surface.
Additionally, melanocytes are located in the basal layer. These are the cells responsible for melanin production. The color of the skin, which can range from exceedingly pale yellow to nearly black, is determined by the number of melanocytes and their activity level.
pigment. The temporary stimulation of these cells to produce more melanin by ultraviolet radiation is commonly known as tanning.
There are numerous specialized structures within the skin, each of which plays an essential role in the overall function of this organ. The most apparent of these is the hair follicle. Each hair follicle produces a single hair, and hair follicles are present to varying degrees in virtually every area of epidermis. Generally the follicles are most numerous and arranged very close together on the top of your head, but that obviously differs from person to person. The shaft of hair, which emerges from the follicle, is composed of extremely durable but dead cellular material bound together by keratin filaments. Hair comes in a variety of colors and textures, including straight and curled, and has a significant impact on our appearance. However, that is not its role.
The primary function of hair is to increase the skin's insulating capacity. Having a lot of hair on your head can be very beneficial on a chilly winter day, and it can also help keep your cranium cool when you're out in the scorching sun. Each hair follicle has a small muscle called the pilo-erector muscle attached to it. When a person is chilly or frightened, all of these tiny muscles contract, causing hair to stand on end. This automatic process alters the passage of air across the skin's surface, thereby increasing its insulating properties.
The sebaceous gland is an additional structure found within the epidermis. These minute organs are closely linked to the hair follicle. They exude an oily substance that lubricates both the hair and the epidermis in the vicinity. Those with oily skin have active sebaceous glands, whereas those with drier skin produce much less of this natural lubricant. This oily substance continually rises to the surface along with the hair shaft through the skin's minute pores.
The skin also contains another type of gland, the sweat gland, which is not the most glamorous but surely one of the most vital components. Each sweat gland has its own microscopic capillaries that lead to the surface. The
Sweating is an essential component of the body's temperature regulation mechanism. When water is secreted from these glands onto the skin's surface, it aids in cooling the body via evaporation, the same process as air conditioning. If you were unable to perspire on a hot day, your body would quickly overheat.
Under extreme conditions, your body may lose as much as one liter of water per hour through this process. As a band patient, you may have trouble drinking enough fluids to avoid dehydration, so this is especially essential. If you become dehydrated, your body will try to retain as much water as possible, and you will eventually cease perspiring. If you do not move to a cooler environment and consume some water, your body temperature will begin to rise uncontrollably. This potentially fatal condition is called heat stroke.
The epidermis contains an extraordinary network of blood vessels and nerve endings. The nerve endings are especially intriguing. The sensation is felt regardless of where it is applied to the epidermis, but it is far more complex than that. It is easy to distinguish between being jabbed with a sharp pin and a blunt finger. Additionally, you know the exact location of the contact. Instantaneously, one can distinguish between the feel of a woolen and a silk scarf. You can even sense the distinction between a dry and slightly damp towel. When you pause to consider it, that is truly remarkable. For instance, if you contact something hot, your hand will immediately recoil before you are aware of the pain. All of these actions are made possible by the remarkable network of nerve endings in the epidermis, which we take for granted.
The skin is affected by excess body fat, but it does not store fat. Subcutaneous adipose tissue is a layer of fatty tissue immediately beneath the epidermis. This is where the majority of fat is stored, particularly in women.
Now that you are completely astonished by what your skin actually does for you, we must return to the topic of obesity and discuss what happens to your skin during weight gain and loss.
What Obesity Does to Your Skin
In the majority of obese individuals, the majority of excess fat is stored in the subcutaneous layer. This is particularly true for overweight women. As previously mentioned, males tend to store a greater proportion of their body fat in the abdomen, but obese men also develop a thick layer of subcutaneous fat. In addition to the accumulation of these fatty deposits, the epidermis must also expand to accommodate the expanding body. If weight gain is gradual, there is a chance that the skin can expand to satisfy the demand. This is more likely to occur in younger individuals with healthy epidermis than in older individuals.
When weight gain is relatively rapid or extreme, regardless of age, the epidermis may not be able to grow quickly enough, so it stretches. This type of skin stretching damages the dense fibrous tissues of the dermis, which contribute significantly to the skin's strength, as well as the elastic fibers that enable the skin to rebound. In other words, epidermis damage can be permanent. The result is commonly known as stretch scars. They are visual indicators of the underlying injury caused by weight gain.
Cellulite
The subcutaneous fat deposition is not always uniform and homogeneous. Occasionally, it can be quite lumpy or cause skin dimples. This is generally known as cellulite. In actuality, they are irregular fat deposits. It has nothing to do with the skin, except that these irregular fat lumps cause the epidermis to conform to their shape. The dimples are caused by random fibrous bands connecting the epidermis to the deeper tissue layers beneath the fat. These dense tissue bands do not stretch as fat accumulates, resulting in the dimples that are sometimes referred to as "hail damage" or "cottage cheese skin."
The treatment of cellulite has become a multimillion dollar industry. Numerous lotions and balms are sold with the promise of making this "unattractive skin simply vanish." In actuality, cellulite is not a cutaneous condition.
condition at all. The appearance is caused by subcutaneous fat accumulation. It may appear that the problem has been resolved after vigorously massaging the affected area with a miracle lotion, but the improvement is more likely due to the mechanical action of massaging than to the chemical being applied. Applying pressure to the epidermis can temporarily redistribute the subcutaneous fat layer. Consequently, various coverings and tight-fitting garments also appear to reduce cellulite. Liposuction has been recommended as a treatment for cellulite, but it may actually exacerbate the problem by causing even more irregular fat deposits. Weight loss is the greatest treatment for cellulite, period.
Skin Fungus
One of the most common issues associated with obesity is the development of a red rash between the skin creases, particularly under the breasts, in the groin, and beneath a large, protruding abdomen. This is a cutaneous infection caused by a fungus, and its medical name is intertriginous moniliasis. Everyone has microscopic spores of fungi on the surface of their skin, but certain conditions are required for them to induce an infection. You can consider cutaneous fungus to be a close relative of mushrooms. It requires a warm, moist, shady, and nutrient-rich environment to grow. This precisely describes the space between the folds of skin: the deeper the fold, the more warmth, moisture, and darkness. The nourishment is provided by the epidermis itself.
Numerous antifungal powders and creams are available to treat athlete's foot, which is caused by effectively the same fungus as athlete's foot. There are also prescription medications, including topical treatments and antifungal tablets, that can aid in the treatment of these infections. However, if the environment that supports fungal growth is not eliminated, the fungus will return. That means you need to keep the area dry and cool-not an easy feat when gravity continues to slam those folds together.
Antifungal powders may aid in moisture absorption, but they must be administered frequently. Placing an absorbent fabric between the skin layers may also be helpful, but the cloth has a tendency to shift and must be repositioned frequently. Probably the most effective treatment is to lie in a cool, dry environment.
twice or three times per day, expose the affected area to light for 30 minutes to one hour. It may sound impractical, but when combined with other antifungal treatments, it is effective.
This type of fungal infection frequently causes permanent discoloration and scarring on the epidermis. If the infection is severe or persists for an extended period, a secondary bacterial cutaneous infection may develop. Patients with diabetes are especially susceptible to bacterial and fungal cutaneous infections due to their compromised immune system. If the fungus enters the bloodstream, it can cause a life-threatening infection. However, cutaneous infections caused by fungi are almost never life-threatening and almost never dangerous.