title: Corticosteroid use in cosmetic plastic surgery.
abstract: BACKGROUND
  Steroids have been used in cosmetic plastic surgery to reduce postoperative edema and ecchymosis. We performed a systematic review of the literature addressing postoperative steroid use after rhinoplasty. Due to a paucity of studies, a review of the literature was also performed for postoperative steroid use in rhytidectomy and body contouring surgery.
  
  
  METHODS
  An exhaustive literature search was performed using: MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and PubMed. A total of 12 articles were chosen to be included in the rhinoplasty systematic review. Cohen's kappa for level of agreement between the two reviewers was 1.0. Data recorded from each of the studies included: author, year, sample size, age, follow-up, statistical analyses, eyelid/edema assessment, significant findings, p values, and steroid regimens. A general review of the current rhytidectomy and body contouring literature associated with corticosteroids was performed as well.
  
  
  RESULTS
  No statistically significant long-term reduction in postoperative edema or ecchymosis after rhinoplasty. Significant reductions were noted in the short term (<2 days). Review of the rhytidectomy literature described no significant decrease in postoperative edema or ecchymosis. Steroid use was noted to reduce postoperative nausea and vomiting when combined with other therapies in body contouring.
  
  
  CONCLUSIONS
  Steroid use is not warranted in the postoperative period and only reduces transient edema and ecchymosis. A significant benefit for steroid use after rhytidectomy is not evident as well. Steroid use may benefit in postoperative nausea and vomiting.
authors.affiliation: Dallas, Texas; and Newark, N.J. From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; and Division of Plastic Surgery, Rutgers New Jersey Medical School.
authors.forename: Benson J
authors.initials: BJ
authors.lastname: Pulikkottil
authors.forename: Phillip
authors.initials: P
authors.lastname: Dauwe
authors.forename: Lily
authors.initials: L
authors.lastname: Daniali
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Rohrich
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003357:Cosmetic Techniques; D004438:Ecchymosis / Q000209:etiology / Q000517:prevention & control*; D004487:Edema / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D012225:Rhinoplasty; D015361:Rhytidoplasty; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents