How Long Should I Be off Accutane Before Revision Rhinoplasty Surgery?

Accutane can have a negative effect on healing of the surgical wound.  Traditionally people have been advised to stay off of this medication for 6-12 months before undergoing elective surgery. Some recent data suggests that such lengthy abstinence might not be necessary. However, if you are considering a revision rhinoplasty that requires alarplasty (with the potential of noticeable unsightly scarring which is difficult to correct) I would err on the cautious side.

Hello and thank you for your question. Low dose Accutane is very safe too remain on during and after rhinoplasty. You can resume it immediately after surgery. It actually helps reduce swelling after rhinoplasty and is very safe. It is only in other larger surgeries such as a tummy tuck you need to wait 6 months. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thanks for sharing the questions! This is a common concern in patients considering rhinoplasty and other facial aesthetic surgery. As a general "rule of thumb", I recommend waiting 6 months. For some cases, such as skin resurfacing, lasers, and deep chemical peels, I recommend waiting a full year.  Although, in some cases I wait longer. Accutane, and other medications, interfere with the skin's healing process. Incisional healing is highly dependent on the sebaceous glands, and cells contained within, for healing. These cells are inhibited by Accutane. For procedures that depend highly on the postoperative appearance of the incision (especially alarplasty!), it is best to wait at least six months. I hope you find this helpful. Thanks again for sharing. Good luck!

Conventional wisdom has traditionally recommends waiting for a patient to be off Accutane at least six months.  More recent evidence suggests that it is safe to go off low dose Accutane 1-2 weeks prior to rhinoplasty and resume 1-2 weeks post-operative. This should be coordinated between the surgeon and the prescribing dermatologist.
Best of luck,
Dr. Kaniff

Thanks for your question.  I would recommend that you remain off of Accutane for as long as your prescribing physician recommends.  This is a medication typically prescribed mainly by dermatologists.  It can have some profound effects on healing.

If Accutane is needed for a patient who is undergoing a rhinoplasty, ideally it should be started about a month or so after the surgery. For the rhinoplsty candidates who have used Accutane already waiting minimum 6 months and preferable a year would be optimal.

You absolutely want to make sure that the sebaceous glands that are inhibited by Accutane are fully functioning before having a scar.  The problem with Accutane is it can create poor wound healing and scarring if it isn't out of your system completely.  In general, most surgeons will wait 6 months but there are several that would wait a full year before operating on someone with recent accutane use. 

If you are thinking about Rhinoplasty surgery and are on Accutane, be aware that you should stop taking the medication 6 months prior to surgery and in some occasions 12 months prior.  Be sure to let your Doctor know that you are taking the medication because it can delay your healing.

You should wait at least six to twelve months following the discontinuation of your Accutane treatment before you have any type of facial surgery. It is safest to wait before having any surgical procedures if at all possible due to potential healing issues with  the Accutane. When considering elective surgery you want to maximize your odds of healing as much as possible.  

Since this is an elective procedure it is always best to minimize the risks.  Having a revision rhinoplasty within 6-12 months of stopping accutane would be a risk.  It could negatively affect wound healing.  It would be in your best interest to wait.  When we have cases like this, I often will work together with the Dermatologist to come up with the safest plan.