Oral Isotretinoin in the Treatment of Postoperative Edema in Thick-Skinned Rhinoplasty: A Randomized Placebo-Controlled Clinical Trial

Sazgar, Amir Arvin; Majlesi, Alireza; Shooshtari, Saeideh; Sadeghi, Mohammad Reza; Amali, Amin

doi:10.1007/s00266-018-1252-5

Cited by 20 publications

(24 citation statements)

References 14 publications

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“…3,4 Therapeutic approaches to improve the quality of this type of skin are necessary to achieve satisfactory cosmetic results in rhinoplasty. 3,4 It is known that the higher the number of sebaceous glands, the oilier the skin and the thicker the dermis, which can worsen in the postoperative period of rhinoplasty. 4,5,8 The oiliness of the skin causes inflammation and fibrosis, two factors that, if controlled before surgery, improve the overall aesthetics of the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…1 It is a complex surgery that can be even more challenging in patients with thick, oily skin that are prone to acne or rosacea. 3,4 Patients of certain ethnic groups, such as Afro-descendant, Mestizo, and Asian patients, tend to have a weaker nasal bone and cartilaginous structure that is usually covered by thicker skin. 5 In addition, acne may increase by up to 27% in the first month after rhinoplasty, thereby generating more local inflammation.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of the use of isotretinoin as an adjuvant in rhinoplasty

Silveira,

Azulay‐Abulafia,

Barcaui

et al. 2023

Int J Dermatology

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BackgroundIsotretinoin has been used in the treatment of acne for decades through the reduction of sebaceous secretion. There are reports in the literature that isotretinoin may be associated with decreased skin thickness, especially in patients with thick nasal skin for whom rhinoplasty can be more challenging. The objective of this study was to quantify, through ultrasonography, the effect of the use of oral isotretinoin in patients undergoing rhinoplasty, pre‐ and postoperatively.MethodsTwenty‐four patients participated in this randomized, single‐blind controlled pilot clinical trial. The intervention group used oral isotretinoin (20 mg/day) for 2 months before rhinoplasty and for 4 months after. Both groups underwent rhinoplasty in the same plastic surgery department and were submitted to high‐frequency (22 MHz) ultrasound evaluation of the epidermis and dermis on the nasal dorsum, nasal tip, and left nose wing at the beginning of the study and 6 months after rhinoplasty, with the aim of assessing changes in skin thickness.ResultsSix months after rhinoplasty, a statistically significant reduction was observed in the thickness of the epidermis and dermis of the nasal dorsum and left nose wing, as well as of the epidermis of the nasal tip, but only in the intervention group. The results of the satisfaction questionnaire were better after rhinoplasty in both groups, with no statistical difference between them regarding the specific questions; however, the intervention group had significantly higher satisfaction scores than the control group.ConclusionsIsotretinoin was effective in reducing the thickness of the skin covering the nose of the evaluated sites.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analysis of the use of isotretinoin as an adjuvant in rhinoplasty

Silveira,

Azulay‐Abulafia,

Barcaui

et al. 2023

Int J Dermatology

View full text Add to dashboard Cite

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“…Isotretinoin (0.5‐mg/kg/day) has been recently used in an off‐label setting after rhinoplasty in thick‐skinned patients to achieve more definition of the nasal tip as well as to diminish scar formation and local inflammation 2,29 . It showed better cosmetic results and patient satisfaction rates on short‐term follow‐up after rhinoplasty without significant healing issues.…”

Section: Postoperative Measuresmentioning

confidence: 99%

“…It showed better cosmetic results and patient satisfaction rates on short‐term follow‐up after rhinoplasty without significant healing issues. However, on a 1‐year follow‐up, there was no significant cosmetic or patient satisfaction improvement 29,30 . This indication is still under debate, and further investigations are needed to assess the efficacy and safety profile, especially since many patients undergoing rhinoplasty surgery are females in reproductive age 1,2,5,6 …”

Section: Postoperative Measuresmentioning

confidence: 99%

“…However, on a 1-year follow-up, there was no significant cosmetic or patient satisfaction improvement. 29,30 This indication is still under debate, and further investigations are needed to assess the efficacy and safety profile, especially since many patients undergoing rhinoplasty surgery are females in reproductive age. 1,2,5,6 A commonly described fact in thick-skinned patients is the presence of increased porosity and rough skin texture following rhinoplasty.…”

Section: Postoperative Measuresmentioning

confidence: 99%

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Dermatological assessment of thick‐skinned patients before rhinoplasty—what may surgeons ask for?

et al. 2022

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Rhinoplasty is considered a very challenging surgery since minimal changes of this central area of the face may significantly impact a person's appearance and self‐awareness. This is even more challenging in thick‐skinned patients because results are less predictable, and changes to the osseocartilaginous framework (OCF) may not be sufficiently visible due to the blanket effect of the thick skin. Furthermore, pre‐existing skin conditions may exacerbate following surgery. Therefore, managing patients with extremely thick skin or patients who suffer from pre‐existing dermatological conditions such as rosacea or acne requires a synergy of surgeons and dermatologists to achieve optimal results. In this article, we review the most significant pre‐ and post‐surgical regimens that surgeons and dermatologists should apply in selected patients to achieve optimal results after rhinoplasty.

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