Doxycycline Sclerodesis-"Rhinodesis"-for Enhanced Soft Tissue Adhesion in Rhinoplasty: A Preliminary Study

Area of Science:

• Plastic Surgery
• Dermatology
• Sclerotherapy

Background:

• Doxycycline is a known sclerosing agent.
• Rhinoplasty can result in surgical dead space and contour issues, especially in thick-skinned patients.
• Minimizing dead space is crucial for optimal surgical outcomes.

Purpose of the Study:

• To evaluate the efficacy of small-volume liquified doxycycline in promoting skin-soft tissue envelope (SSTE) re-adhesion after rhinoplasty.
• To assess doxycycline's ability to minimize surgical dead space and enhance surface contour in rhinoplasty patients.
• To investigate the use of doxycycline as a sclerosing agent in rhinoplasty, particularly for thick-skinned individuals.

Main Methods:

• Two clinical case series involving open rhinoplasty were conducted.
• A doxycycline solution (20 mg/mL) was applied to the dead space beneath the skin flap and retained for 2-3 minutes.
• Patients received conventional splinting and taping; one group was evaluated with serial postoperative ultrasonography.

Main Results:

• Enhanced skin adherence was observed in nearly all patients compared to traditional methods.
• Ultrasonic examination confirmed improved adherence of subcutaneous tissue to the nasal framework.
• Doxycycline effectively minimized dead space in the majority of thick-skinned rhinoplasty patients without complications.

Conclusions:

• Doxycycline is a safe and effective agent for sealing surgical dead space post-rhinoplasty.
• This technique minimizes contour degradation and improves surgical outcomes.
• Doxycycline offers a valuable adjunct for rhinoplasty, especially in challenging cases with thick skin.