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Facial Plast Surg 2018; 34(01): 075-081
DOI: 10.1055/s-0037-1617446
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Indications and Use of Isotretinoin in Facial Plastic Surgery

Markus V. Heppt   *
1   Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
,
Michael C. Kirchberger   *
2   Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
,
Thomas Ruzicka
1   Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
,
Carola Berking
1   Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
,
Werner J. Heppt
3   Skin and Face Clinic, Baden-Baden, Germany
› Author Affiliations
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Publication History

Publication Date:
06 February 2018 (online)

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Abstract

Isotretinoin is a first generation retinoid with pleiotropic effects on keratinocyte differentiation, proliferation, and activity of sebaceous glands. For years, there has been intense debate on whether the use of isotretinoin combined with cosmetic or surgical procedures is safe and potentially more efficient than either therapy alone. Due to delays in wound healing and keloid formation, conservative recommendations were not to combine isotretinoin with any plastic surgery or local treatment at 6 to 12 months after discontinuation of the drug. However, there is increasing evidence that a combination approach is not only safe, but may also provide excellent cosmetic outcomes in acne scars, sebaceous gland hyperplasia, and thick-skinned patients undergoing facial plastic surgery. In particular, low-dose regimens of isotretinoin may offer advantages over standard dosage treatments because of better tolerability and safety in long-term use adjunct with surgical interventions. In this article, the authors aim to summarize the current evidence on the use of isotretinoin in facial plastic surgery and to share their experience from selected patients.

Keywords

isotretinoin - acne - scars - laser - facial plastic surgery

* Both authors have contributed equally to this article.