Metabolic syndrome (MS) combines abdominal obesity, insulin resistance, dyslipidemia, and hypertension, leading not only to cardiometabolic complications but also to chronic microcirculation disorders, inflammation, and connective tis- sue remodelling. Therefore, studying the functional state of the skin and subcutaneous adipose tissue in patients with MS is important for optimising preoperative preparation, selecting the scope of intervention, and postoperative management. The aim of our study was to assess the functional state of the skin and subcutaneous adipose tissue in 49 patients aged 27-82 years with MS who sought surgical help for cosmetic defects of the skin and subcutaneous adipose tissue of the anterior abdominal wall. Two groups of patients were examined. The insight into diabetic wounds: Pathogenesis, molecular targets and treatment strategies to pace wound healing. first group, the control group, comprised 24 practically healthy individuals. The second group comprised 25 patients with MS, which was verified based on anthropometric and laboratory criteria. The functional state of the skin was studied using comprehensive non-invasive methods: a skin moisture and oiliness analyzer (SK-92), vacuum aspiration elastometry, as- sessment of the duration of stratum corneum exfoliation, and neutralisation of the irritant. In addition, skin quality indica- tors (hydration, softness, oiliness) were analysed in standard anatomical areas (shoulder, abdomen, thigh) depending on the time after surgery (≤6, 6–12, ≥12 months) and the presence of MS. In patients with MS, compared with the control group, a significant prolongation of the duration of exfoliation of the stratum corneum (3.11 ± 0.15 vs. 2.10 ± 0.17 days) and the time of neutralization of the irritant (6.70 ± 0.16 vs. 5.40 ± 0.13 min) was found, which indicates a decrease in the rate of basal keratinocyte division and a deterioration in the barrier function of the skin. The elastometric index was higher in the MS group (6.13 ± 0.08 vs. 4.20 ± 0.06 mm), indicating a reduction in elasticity and altered mechanical properties of the skin. In the period up to 6 months after plastic surgery, patients with MS had worse hydration and less favorable mechanical characteristics of the skin, especially in the abdominal area; between 6-12 months and ≥12 months, the indicators im- proved in both groups, but in patients with MS, normalization was incomplete, with lower hydration and relatively higher abdominal skin oiliness remaining. The changes identified explain the increased risk of impaired repair and wound heal- ing complications in this category of patients and justify the need for a personalised approach to preoperative preparation and postoperative management of patients with MS.