Aesthetic Plastic Surgery

, Volume 40, Issue 1, pp 139–148 | Cite as

Is It Safe to Operate on Patients Taking Isotretinoin?

  • Luís Fernando Ungarelli
  • Cristina Marly Cunha Hetem
  • Jayme Adriano Farina Junior
Original Article Experimental/Special Topics



Oral isotretinoin is increasingly being used to treat acne and other dermatological conditions. The number of patients who take isotretinoin and wish or need to undergo plastic surgery may be following a similar pattern. Although skin healing is an important concern in the case of patients who use isotretinoin, it is definitely not the only relevant issue when planning surgical intervention.


Eleven important points regarding surgery safety in patients taking oral isotretinoin were defined. A literature search of the PubMed database was conducted by employing the keywords isotretinoin OR 13-cis-retinoic acid. This returned the largest possible number of studies about isotretinoin.


Forty-seven studies matched the selection criteria. Most animal experimental models suggested that isotretinoin at doses commonly used to treat acne is not detrimental to wound healing. Human studies are controversial. However, healing of skeletal muscle could be at increased risk of necrosis.


Association between isotretinoin and problematic skin healing after surgery is being challenged. Also, recommended time between discontinuation of isotretinoin and surgery should be reviewed. While muscle flaps may be endangered in patients taking isotretinoin, healing of other tissues and systemic effects that could compromise surgery safety are rare or detectable before surgery.

Level of Evidence V

This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings please refer to the Table of Contents or the online Instructions to Authors


Isotretinoin 13-cis-retinoic acid Surgery Safety 


Compliance with Ethical Standards

Conflict of interest

The authors have no financial interest to declare in relation to the content of this article.


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Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2015

Authors and Affiliations

  • Luís Fernando Ungarelli
    • 1
  • Cristina Marly Cunha Hetem
    • 1
  • Jayme Adriano Farina Junior
    • 2
  1. 1.Division of Plastic Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoBrazil
  2. 2.Division of Plastic Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical SchoolUniversity of São PauloSão PauloBrazil

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