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

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.

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