Análise do uso da isotretinoína como adjuvante na rinoplastia

Abstract

Introduction: Patients with thick skin covering the nose may have less satisfactory results from rhinoplasty. Isotretinoin is the medication used to treat acne that provides a reduction in sebaceous secretion, which may be associated with a decrease in skin thickness, leading to better final results in rhinoplasty, when associated. Ultrasonography of the skin is an objective test to assess the thickness of the epidermis and dermis, helping to evaluate the benefits of using isotretinoin in the preoperative and postoperative periods. Objective: Evaluate the effect of the use of oral isotretinoin in the preoperative and postoperative periods of patients undergoing rhinoplasty. Methods: Twenty-four patients participated in this randomized, single-blind controlled pilot clinical trial. The intervention group used oral isotretinoin (20mg/day) for two months before rhinoplasty and for four months after. Both groups underwent rhinoplasty in the same plastic surgery department and underwent evaluation of satisfaction with the appearance of the nose using the Utrecht questionnaire. All patients were examined using high-frequency ultrasound (22MHz) to assess the thickness of the epidermis and dermis on the nasal dorsum, nasal tip and left nasal wing at the beginning of the study and six months after rhinoplasty. Aiming to measure patient satisfaction and changes in the thickness of the skin covering the nose. Results: Six months after rhinoplasty, a statistically significant reduction was observed in the thickness of the epidermis and dermis of the nasal dorsum and left nose wing, as well as of the epidermis of the nasal tip, but only in the intervention group. The results of the satisfaction questionnaire were better after rhinoplasty in both groups, with no statistical difference between them regarding the specific questions; however, the intervention group had significantly higher satisfaction scores than the control group. As a conclusion of our study, isotretinoin proved to be effective in reducing the thickness of the skin covering the nose in points evaluated with statistical significance in the group in which the intervention took place. There was satisfaction with rhinoplasty in both groups, although there was no statistical difference between them.