Optimizing Rhinoplasty Outcomes: The Role of Isotretinoin and Patient Management Strategies: Systematic Review

Area of Science:

• Plastic Surgery
• Dermatology
• Otolaryngology

Background:

• Thick nasal skin in rhinoplasty can complicate aesthetic outcomes and prolong edema.
• Isotretinoin is a known treatment for acne and excessive oiliness.

Purpose of the Study:

• To systematically review the efficacy and safety of isotretinoin as a perioperative adjunct in rhinoplasty for patients with thick nasal skin.

Main Methods:

• A PRISMA-guided systematic review of PubMed, Scopus, Web of Science, and Embase databases up to March 2025.
• Included RCTs, cohort, and retrospective studies on rhinoplasty with isotretinoin, analyzing outcomes like skin thickness, edema, and patient satisfaction.
• Assessed risk of bias using Joanna Briggs Institute tools.

Main Results:

• Seven studies (3 RCTs, 4 cohort) showed isotretinoin improved nasal tip definition and reduced postoperative edema.
• Observed decreased sebaceous gland activity and improved patient satisfaction; wound healing appeared accelerated.
• Adverse effects were mild (mucosal dryness, cheilitis); some cases required revision surgery.

Conclusions:

• Isotretinoin shows promise for improving aesthetic and wound-healing results in rhinoplasty for thick-skinned patients.
• Individualized treatment and close monitoring are key; a favorable safety profile was noted.
• Further large-scale RCTs are necessary to refine dosage and protocols.