Clarifying the Role of Isotretinoin in Rhinoplasty: A Systematic Review and Analysis of an Emerging Social Media Trend

Fanning JE, Foster L, Manik D, Lee D, Foppiani J, Escobar-Domingo MJ, Rahmani B, Park JB, Lee BT, Lin SJ.

PubMed 41184659 Publisher (DOI)Free full text (PMC)

What this paper says

Only five small studies address isotretinoin around rhinoplasty, with mixed findings, while TikTok videos under "Accutane nose job" hashtags have 68.5 million views, 90% of them from patients claiming their nose shrank.

Overview

A TikTok trend presents the acne drug isotretinoin as a non-surgical way to shrink the nose. The Boston authors ran a PRISMA systematic review (MEDLINE, Web of Science, EMBASE, December 2024) of studies on rhinoplasty patients treated with oral isotretinoin, and separately scraped 100 English-language TikTok reels under three hashtags posted to September 2024.

Sections of note

Five articles met criteria; median 24 patients per study; isotretinoin given postoperatively in all and preoperatively in two.
Two of three prospective studies reported benefits: less facial acne, thinner facial skin, higher satisfaction.
Retrospective studies were mixed: better nasal skin appearance, but also more rhinoplasty complications and isotretinoin side effects.
TikTok: 68.5 million views; 100 reels reviewed; 10% from self-reported physicians, 90% from patients reporting nasal size reduction.
Level of Evidence II (as assigned).

What it means for a patient

Isotretinoin can thin oily, thick nasal skin, which some surgeons use to improve definition after rhinoplasty in selected patients.
It does not shrink the nose; it changes skin thickness and oiliness.
It is a powerful drug with serious side effects and impaired wound healing; it should never be taken for cosmetic nasal change without medical supervision.

Why this paper matters

It confronts a viral misconception with the actual evidence base. Limits: five small heterogeneous studies; TikTok analysis is descriptive.

Terms

Isotretinoin (Accutane): an oral retinoid for severe acne that shrinks sebaceous glands.
Sebaceous skin: thick, oily skin with large oil glands, common on the nasal tip.
Systematic review: a structured search and appraisal of the literature.
PRISMA: reporting guidelines for systematic reviews.

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

Abstract

Purpose: A recent TikTok trend of users reporting nasal size reduction after oral isotretinoin has conflated this acne medication as a nonsurgical rhinoplasty option, termed "Accutane rhinoplasty". We conducted a systematic review of studies reporting outcomes of rhinoplasty and oral isotretinoin and analyzed TikTok reels published under this emerging aesthetic trend.

Methods: A comprehensive systematic literature search was conducted in December 2024 using the MEDLINE, Web of Science, and EMBASE databases following PRISMA guidelines. Studies reporting outcomes of rhinoplasty patients treated with oral isotretinoin were included. TikTok Scraper extracted details of English-language TikTok reels posted up to September 2024 under three hashtags: #accutanenosejob, #accutanenose, and #accutanenosejobcheck.

Results: Five articles met inclusion criteria. Studies included a median of 24 patients, with isotretinoin administered postoperatively in all studies and preoperatively in two studies. Two of three prospective studies reported positive findings, including lower frequency of facial acne, reduced facial skin thickness, and higher patient satisfaction. Retrospective studies reported mixed findings, including improved nasal skin appearance, increased rhinoplasty complications, and isotretinoin side effects. TikTok hashtags have 68.5 million views, and 100 reels were included for review. Self-reported physicians represented 10% (10/100) of reels and self-reported patients reporting nasal size reduction after isotretinoin represented 90% (90/100) of reels.

Conclusions: Current evidence on isotretinoin use in rhinoplasty patients is limited, with small sample sizes and mixed findings. While some studies suggest potential benefits in patients with thick nasal skin or severe acne, the long-term effects and safety profile remain unclear. The popularity of "Accutane rhinoplasty" on TikTok contrasts with the scarcity of rigorous clinical data, underscoring the need for further high-quality studies and greater clinician engagement in online discussions.

Level Of Evidence Ii: Therapeutic study. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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).