Isotretinoin in Thick-Skin Rhinoplasty: A Review

TL;DR

This paper reviews how isotretinoin can help in rhinoplasty for patients with thick skin, focusing on its effects and best practices.

Contribution

The paper provides a systematic review of isotretinoin's role in thick-skin rhinoplasty, highlighting its effectiveness and limitations.

Findings

Low-dose isotretinoin for up to 6 months improves skin quality and patient satisfaction post-rhinoplasty.

After 6 months, isotretinoin does not significantly affect patient satisfaction rates.

Surgical techniques may be more important than isotretinoin for long-term outcomes.

Abstract

Introduction
 Thick-skinned patients are prevalent in the general population worldwide and represent a challenge for the rhinoplasty surgeon. The use of oral isotretinoin before and/or after surgery is a possible adjuvant treatment that can facilitate intraoperative management and improve results in the postoperative stages; however, there are still questions about its effects in the long-term.

Objective
 To evaluate the advantages and best practices for orally administrated isotretinoin in thick-skin rhinoplasty based on the current literature.

Methods
 An advanced search was conducted until August 31st, 2023, on the PubMed, Cochrane Library, ClinicalTrials.gov, Embase, and LILACS databases with the keywords
rhinoplasty
and
isotretinoin
. Sixteen articles were reviewed and 4 met the inclusion criteria, with a total of 371 patients. Meta-analysis of the data collected was not possible due to heterogeneity among papers.

Conclusion
 Isotretinoin can be a safe drug, and its use in rhinoplasty varies widely, although all studies reported a low-dose oral regime for up to 6 months. The medication use is well-established in thick-skin rhinoplasty. Small doses after the procedure can improve patient satisfaction and the quality and thickness of the skin in the first 6 months of postsurgery. After 6 months, studies with a control group did not show a significant difference in patient satisfaction rates. A strong framework and specific surgical maneuvers may be more important than isotretinoin for better outcomes in thick-skin rhinoplasty.

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