MODULATION OF NASAL SKIN THICKNESS WITH ISOTRETINOIN: ENHANCEMENT OF RESULTS IN RHINOPLASTY

Introduction: The thickness and sebaceous nature of nasal skin are critical determinants in the planning and outcome of rhinoplasty procedures. Thicker skin is commonly associated with poor definition and unpredictable healing, particularly in patients undergoing tip refinement. Recent literature has explored the use of isotretinoin, a retinoid known for its sebosuppressive and keratinocyte-modulating effects, to optimize skin parameters before nasal surgery. Objective: To evaluate current evidence on the role of isotretinoin in modulating nasal skin thickness and sebaceous gland activity to improve aesthetic and functional outcomes in rhinoplasty. Methods: A comprehensive narrative review was conducted using PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar databases. Studies published within the last five years were prioritized. Clinical trials, cohort studies, case reports, and reviews were considered. Search terms included "isotretinoin," "rhinoplasty," "nasal skin," and "sebaceous modulation." Results and Discussion: Isotretinoin has shown promising results in reducing sebaceous gland size and skin thickness, potentially allowing for better redraping and aesthetic refinement in rhinoplasty. Its role as a preconditioning agent must be weighed against adverse effects and patient-specific factors. The reviewed literature supports a cautious and individualized approach, particularly in patients with oily or thick nasal skin phenotypes. Conclusion: The modulation of nasal skin characteristics using isotretinoin represents a valuable adjunct in rhinoplasty planning. Future controlled studies are needed to define protocols, optimal dosing, and safety margins. Multidisciplinary collaboration between dermatologists and facial plastic surgeons is essential to ensure efficacy and minimize risks.