One of the characteristics of mestizo patients can be the thick sebaceous skin associated
with a poor osteocartilaginous underlying nasal structure. In spite of using a proper
structural approach where grafts and sutures are used to define the nasal tip, frequently
the results are suboptimal. Surgical techniques have been described to reduce the
thickness of the skin-soft tissue envelope, but these frequently give unreliable results.
The monitored use of isotretinoin given orally as a complement after performing a
rhinoplasty can adequately control the production of the sebaceous glands and thin
the skin-subcutaneous tissue envelope in a uniform fashion without compromising the
underlying bony and cartilaginous structures of the nose. Patients ideally should
be treated jointly with a dermatologist and be followed closely to monitor hepatic
function. Follow-up after 2 years with pre- and postoperative pictures shows improved
definition of the nasal tip and dramatic improvement on sebaceous gland production.
Keywords
mestizo - rhinoplasty - thick skin - isotretinoin - acne
