Analysis of the Effects of Isotretinoin on Rhinoplasty Patients

Yahyavi S, Jahandideh H, Izadi M, Paknejad H, Kordbache N, Taherzade S.

What this paper says

Among 350 rhinoplasty patients, those taking isotretinoin from 2 weeks before surgery to 2 months after were significantly more satisfied at 1 and 3 months, with no evidence of impaired healing or cartilage deformity.

Overview

Surgeons have avoided operating on patients who have taken isotretinoin, on concern that it impairs wound healing. This study gave the drug deliberately around the time of rhinoplasty and compared outcomes against controls over the following year.

Sections of note

350 rhinoplasty patients divided into control and experimental groups, operated between 2012 and 2015.
The experimental group took isotretinoin from 2 weeks before surgery to 2 months after.
Comparisons were made at 1, 3, 6 and 12 months after surgery.
Satisfaction in the experimental group at months 1 and 3 was significantly higher than controls, P below 0.01.
Examination found little evidence of soft tissue repair disturbance or cartilage deformities.
Nine experimental group patients needed revision surgery, none for a cause clearly attributable to isotretinoin.
The authors conclude the drug causes no evident disturbance to healing of incisions or internal structures, and that treated patients had fewer skin problems.

What it means for a patient

The long-standing concern about operating on someone taking isotretinoin was not borne out here.
The satisfaction advantage appeared at 1 and 3 months, and the abstract does not report whether it persisted at 6 and 12 months.
Isotretinoin has significant side effects requiring monitoring, none of which are reported in this abstract.
Limits: group sizes not stated, not described as randomized, one setting, and satisfaction measured without a stated instrument.

Why this paper matters

The prohibition on surgery during or shortly after isotretinoin has been based on older case reports rather than controlled data, and it restricts treatment for patients with acne-prone skin. A 350-patient comparison is substantial. The absence of randomization, group sizes and side effect data limits the conclusions.

Terms

Isotretinoin: An oral vitamin A derived drug that reduces oil gland activity, used for severe acne.
Perioperative: Around the time of the operation.
Soft tissue repair: Healing of skin and underlying tissue after surgery.
Hypertrophic tissue: Overgrown scar tissue raised above the surrounding skin.
Revision surgery: A further operation to correct or improve the result.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Although the number of cosmetic surgeries performed per year continues to increase, many candidates have skin problems. Thick-skinned rhinoplasty patients pose a real challenge for surgeons. Fear of performing surgery in patients with a history of isotretinoin use is another concern. Objectives: The aim of this study…”

Excerpt; the full abstract is on PubMed.