An Ultrasound-Based Evaluation of Nasal Skin in Patients Using Systemic Isotretinoin After Rhinoplasty: A Randomized Clinical Trial Publisher



Heidari F ; Kaedi Z ; Htami N ; Alipour S ; Mousavi P ; Tajdini A
Source: European Journal of Plastic Surgery Published:2025

Abstract

Background: Various non-surgical interventions may be employed before or after rhinoplasty to optimize results. These interventions include taping, medications such as isotretinoin, laser treatments, and skin therapies. This randomized clinical trial aimed to evaluate the impact of isotretinoin on nasal skin thickness following rhinoplasty. Rhinoplasty is commonly performed to improve nasal function and appearance, and isotretinoin is increasingly considered for its potential benefits in reducing skin thickness, particularly in patients with thick nasal skin. Despite concerns about delayed wound healing, isotretinoin’s role in post-rhinoplasty care remains under investigation. Methods: A total of 42 patients with thick nasal skin (≥ 0.9 mm supratip dermis) were randomly assigned to either the intervention group (treated with isotretinoin) or the control group (no treatment). Isotretinoin was administered 1 month post-surgery, at a dose of 20 mg every other day for six months. Ultrasound measurements of dermis and hypodermis thickness at the nasal tip, supratip, and keystone areas were taken preoperatively and at 3, 6, and 12 months post-surgery. Statistical analyses were conducted using repeated measures ANOVA and ANCOVA to evaluate the effect of isotretinoin on nasal skin thickness. Results: No significant differences in skin thickness were observed between the two groups at 3 and 12 months post-surgery. A statistically significant decrease in supratip skin thickness was noted at 6 months in the isotretinoin group (p = 0.033). However, the effect size was small (24%). Age was found to moderate the treatment effect, with younger patients showing more noticeable changes. Conclusions: Isotretinoin resulted in a modest reduction in nasal skin thickness at 6 months post-surgery, but no significant long-term differences were observed. The findings suggest that isotretinoin has minimal clinical benefit in reducing skin thickness after rhinoplasty. Surgeons should carefully weigh potential benefits against side effects when considering isotretinoin for post-surgical care. Further studies with larger sample sizes and long-term follow-up are needed. Level of Evidence: Level III, therapeutic study. © 2025 Elsevier B.V., All rights reserved.