Isoretinoin is believed to lead to delayed healing or Keloid scarring post-operatively if use is not discontinued prior. Most surgeons will recommend a 6-12 month delay.That being said, this is being challenged with recent studies suggesting that the risk is not as great as has been traditionally believed. A review of the literature published in JAMA 2017 suggested that the risk remained for mechanical dermabrasion, fully ablative laser procedures. However, many procedures once believed to be too risky have been found to be safer than originally thought including manual dermabrasion, microdermabrasion, fractional ablative and fractional nonablative procedures, chemical peels, laser hair removal, or cutaneous surgery. More clinical trials specifically looking at these are underway.With regards to your specific question, an augmentation is technically a cutaneous surgery. There are still warnings regarding muscle flap surgery, however, this would not necessarily apply to augmentation surgery. All of this being said, in my practice I still recommend a delay for patients on Accutane.As always, discuss your concerns with a board certified plastic surgeon (ABPS).Donovan Rosas MD
