Do I Need to Stop Accutane (Isotretinoin) Before Rhinoplasty?
⚠️ Contact your surgeon if you notice these warning signs after rhinoplasty
If you develop unusual swelling, increased redness, wound opening, signs of infection (warmth, pus, fever), or any unexpected changes around your nose after surgery, contact your surgeon promptly. These could signal a complication that needs immediate attention.
Short answer
The answer is nuanced. Some surgeons ask patients to pause Accutane before rhinoplasty due to older concerns about wound healing, but recent evidence suggests it does not clearly increase serious surgical complications and may even help patients with thick nasal skin. The decision should be made together by your surgeon and dermatologist based on your individual situation.
What the research shows
For decades, a common rule was to stop isotretinoin (Accutane) 6 to 12 months before any surgery. However, a large 2017 systematic review covering 1,485 procedures found insufficient evidence to support routinely delaying cutaneous surgery for patients currently on or recently off isotretinoin. The main exception was mechanical dermabrasion and fully ablative laser, which are not rhinoplasty itself. [8]
Specifically for rhinoplasty, multiple recent reviews found that isotretinoin can actually reduce nasal skin thickness, decrease postoperative swelling, and improve patient satisfaction, especially in people with thick or oily nasal skin. [2][4][6] One small randomized controlled trial confirmed measurable skin thinning and higher satisfaction scores in patients who used isotretinoin before and after rhinoplasty. [3]
That said, some studies note that continuous use before rhinoplasty may affect wound healing in certain patients and can influence blood test results, so hematological monitoring is recommended. [1]
What this means for you
The old rule of automatically stopping Accutane months before rhinoplasty is not well-supported by current evidence for most patients. In fact, for patients with thick, sebaceous nasal skin, some surgeons now use low-dose isotretinoin as a planned part of their rhinoplasty preparation and recovery. [2][4]
However, every patient is different. Your surgeon and dermatologist need to weigh your skin type, your acne severity, your surgical plan, and your overall health before deciding whether to continue, pause, or stop isotretinoin around your procedure. [1][6] There is no single correct answer for everyone.
What to ask your surgeon
- Do I have thick or sebaceous nasal skin that might benefit from isotretinoin before or after surgery?
- What is your specific experience managing patients on isotretinoin around rhinoplasty?
- Should I have blood tests to check my levels while on isotretinoin? [1]
- Can my dermatologist and rhinoplasty surgeon coordinate on a plan together?
Bring both your dermatologist and your surgeon into the conversation so they can create a coordinated, personalized plan for you. [1][2]
Caveats
Most studies on this topic are small, and several reviews note that large, high-quality randomized trials are still needed to establish the ideal dose and timing of isotretinoin around rhinoplasty. [2][4] The existing evidence is promising but not yet definitive. Guidelines may also vary between countries and surgical practices. Always follow the specific advice of your own medical team.