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

  • Amir A. Sazgar
  • Alireza Majlesi
  • Saeideh Shooshtari
  • Mohammad Sadeghi
  • Amir K. Sazgar
  • Amin Amali
Original Article Rhinoplasty
  • 52 Downloads

Abstract

Background

The thick-skinned nose is still one of the most challenging aspects of rhinoplasty. The possible effects of oral isotretinoin on cosmetic results of rhinoplasty in patients with thick nasal skin have been considered during recent years.

Methods

In this double-blind placebo-controlled clinical trial, 48 cases were divided into two groups randomly. Oral isotretinoin (0.5-mg/kg) was started on the 31st day after surgery and given every other day for 1 month and after that daily for two additional months in the first group. The second group received a placebo in the same form, sequence and interval as the first group. The cosmetic results based on patient satisfaction and ranking by an expert surgeon were compared between the two groups at 3 months, 6 months and 1 year after surgery.

Results

Patient satisfaction and ranking by an expert surgeon in the isotretinoin group at 3 months and 6 months after surgery were significantly better than in the placebo group (p value < 0.05); however, at 12 months after surgery there was no statistically significant difference between the two groups (p value > 0.05).

Conclusion

Though postoperative use of oral isotretinoin in patients with thick nasal skin accelerates improvement in cosmetic results during the early months after surgery, it does not significantly affect the final cosmetic result 1 year after surgery.

Level of Evidence II

This journal requires that 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 www.springer.com/00266.

Keywords

Rhinoplasty Oral Isotretinoin Postoperative edema Thick skin 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest to disclose.

References

  1. 1.
    Guyuron B, Lee M (2017) An effective algorithm for management of noses with thick skin. Aesth Plast Surg 41:381–387CrossRefGoogle Scholar
  2. 2.
    Sazgar AA, Most SP (2011) Stabilization of nasal tip support in nasal tip reduction surgery. Otolaryngol Head Neck Surg 145:932–934CrossRefGoogle Scholar
  3. 3.
    Nemati S, Golchay J, Iranfar K, Alizadeh A (2013) Frequency of acne vulgaris and its exacerbation in facial and periorbital area after septorhinoplasty. Am J Otolaryngol 34:378–381CrossRefGoogle Scholar
  4. 4.
    Sadeghi M, Saedi B, Safavi A, Iri MR (2012) Postrhinoplasty acne formation: a case–control study. B-ENT 9:95–100Google Scholar
  5. 5.
    Beckenbach L, Baron JM, Merk HF, Löffler H, Amann PM (2015) Retinoid treatment of skin diseases. Eur J Dermatol 25:384–391PubMedGoogle Scholar
  6. 6.
    Fox LP, Merk HF, Bickers DR (2006) Dermatopharmakologie. In: Brunton LL, Lazo JS, Parker KL (eds) Goodman & Gilman’s—Pharmakologische Grundlagen der Arzneimitteltherapie. ABW Wissenschaftsverlag GmbH, Berlin, pp 1–73Google Scholar
  7. 7.
    Dispenza MC, Wolpert EB, Gilliland KL, Dai JP, Cong Z, Nelson AM, Thiboutot DM (2012) Systemic isotretinoin therapy normalizes exaggerated TLR-2-mediated innate immune responses in acne patients. J Invest Dermatol 132:2198–2205CrossRefGoogle Scholar
  8. 8.
    Ungarelli LF, Hetem CM, Farina Junior JA (2016) Is it safe to operate on patients taking isotretinoin? Aesthet Plast Surg 40:139–148CrossRefGoogle Scholar
  9. 9.
    Bagatin E, Guadanhim LR, Yarak S, Kamamoto CS, Almeida FA (2010) Dermabrasion for acne scars during treatment with oral isotretinoin. Dermatol Surg 36:483–489CrossRefGoogle Scholar
  10. 10.
    Sardana K, Garg VK (2011) Low-dose isotretinoin in acne vulgaris: a critical review. Br J Dermatol 165:698–700CrossRefGoogle Scholar
  11. 11.
    Cobo R, Vitery L (2016) Isotretinoin use in thick-skinned rhinoplasty patients. Facial Plast Surg 32:656–661CrossRefGoogle Scholar
  12. 12.
    McLane J (2001) Analysis of common side effects of isotretinoin. J Am Acad Dermatol 45:S188–S194CrossRefGoogle Scholar
  13. 13.
    Allen BC, Rhee JS (2005) Complications associated with isotretinoin use after rhinoplasty. Aesthet Plast Surg 29:102–106CrossRefGoogle Scholar
  14. 14.
    Kosins AM, Obagi ZE (2017) Managing the difficult soft tissue envelope in facial and rhinoplasty surgery. Aesthet Surg J 37(2):143–157CrossRefGoogle Scholar
  15. 15.
    Roberts WE (2008) The Roberts skin type classification system. J Drugs Dermatol 7:452–456PubMedGoogle Scholar
  16. 16.
    Roberts WE (2009) Skin type classification systems old and new. Dermatol Clin 27:529–533CrossRefGoogle Scholar
  17. 17.
    Cho GS, Kim JH, Yeo NK, Kim SH, Jang YJ (2011) Nasal skin thickness measured using computed tomography and its effect on tip surgery outcomes. Otolaryngol Head Neck Surg 144(4):522–527CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  1. 1.Department of Otolaryngology, Head and Neck Surgery, Otorhinolaryngology Research Center, Vali-Asr Hospital, Imam Khomeini Medical ComplexTehran University of Medical SciencesTehranIran

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