Effect of Medical Ozone Therapy in Preventing Compromised Nasal Skin in Revision Rhinoplasty

Alp A, Polat E, Yenigun A, Pasin O, Ozturan O.

PubMed 38987315 Publisher (DOI)Free full text (PMC)

What this paper says

Among 523 revision rhinoplasties, 2.3% had major skin complications, and patients who accepted three post-surgery ozone autohemotherapy sessions had statistically fewer skin problems (2 of 12 major complications versus 10 of 12 in the untreated).

Overview

Skin survival is the critical risk in multiply operated noses. The Turkish authors reviewed 523 revision patients operated by the first author from January 2017 to January 2024. Those who consented received three sessions of major autohemotherapy with ozone after surgery. Patients were grouped by whether they developed compromised skin (infection, poor vascular supply) or healed normally, with age, sex, smoking, diabetes, prior surgeries, graft materials and technique recorded.

Sections of note

12 of 523 (2.3%) had major skin complications (infection, necrosis); 511 (97.7%) had none or minor issues such as discolouration.
301 patients received ozone therapy.
Among the 12 with major complications, 2 (16.7%) had received ozone and 10 (83.3%) had not (p < 0.05).
Rib cartilage used as tip and septal extension grafts was associated with skin problems (p < 0.05).
No major adverse effects of ozone. Level of Evidence IV.

What it means for a patient

Skin breakdown after revision rhinoplasty is uncommon (about 1 in 43 here) but serious.
Ozone therapy was linked to fewer skin problems, but patients chose whether to have it, so healthier or more motivated patients may have opted in.
Stiff rib grafts under thin revision skin were a risk factor in this series.

Why this paper matters

It is a large revision series proposing an inexpensive adjunct for skin protection. Limits: retrospective, self-selected treatment, only 12 events, single surgeon.

Terms

Major autohemotherapy: drawing blood, mixing it with ozone gas, and reinfusing it.
Necrosis: tissue death from lost blood supply.
Compromised skin: skin with poor circulation, at risk of breakdown.
Septal extension graft: cartilage fixed to the septum to support the tip.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

Abstract

Background: Ozone is often used as an additive therapy for skin conditions like infectious diseases, wound healing, diabetic foot, and pressure ulcers. The viability of the nasal skin has crucial importance in revision rhinoplasty cases. The study investigates the potential benefits of medical ozone therapy in healing the nasal skin in multiple-operated cases.

Methods: The study retrospectively examined 523 revision rhinoplasty patients operated by the first author from January 2017 to January 2024. Patients consenting to ozone therapy received 3 major autohemotherapy sessions post-surgery. Patients were divided into 2 groups: those with compromised nasal skin (infection, poor vascular supply) and those with normal healing. Age, gender, smoking, diabetes, previous surgeries, grafting materials, and techniques were considered.

Results: Of the 523 patients, 12 (2.3%) experienced major skin complications like infection and necrosis, while 511 (97.7%) had no or minor issues, such as discoloration. In total, 301 patients accepted and received ozone therapy. Of the patients without major complications, 299 (58.3%) received ozone therapy, while 212 (41.7%) did not. Among the 12 with major complications, two (16.7%) received ozone therapy, and the remaining 10 (83.3%) did not. Ozone therapy recipients showed statistically fewer skin problems (p<0.05). Costal cartilage as tip and septal extension graft was linked to skin issues (p<0.05). No major adverse effects from ozone therapy were noted.

Conclusions: Our findings indicate that ozone therapy may be a safe and potentially effective option for patients undergoing revision rhinoplasty, especially those with compromised nasal skin. It appears to aid in skin healing and regeneration, possibly through enhancing oxygen delivery and modulation of the immune response. Ozone therapy is a promising adjunct treatment for managing skin complications in revision rhinoplasty patients.

Level Of Evidence Iv: 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 .

Abstract as indexed by PubMed; the article is open access (PubMed Central).