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Facial Plast Surg
DOI: 10.1055/a-2541-2644
Original Research

5-Fluorouracil in Facial Plastic Surgery: Indications, Efficacy, and Safety – A Systematic Review and Narrative Synthesis

Ahmad Bogari 
1   Department of Otolaryngology, Head and Neck Surgery, Facial Plastic Surgery Unit, King Saud University College of Medicine, Riyadh, Riyadh Province, Saudi Arabia
,
Mohammed Jomah
1   Department of Otolaryngology, Head and Neck Surgery, Facial Plastic Surgery Unit, King Saud University College of Medicine, Riyadh, Riyadh Province, Saudi Arabia
,
Naif Alshehri
2   College of Medicine, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
,
Hamad F. Alrabiah
2   College of Medicine, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
,
Abdullah Binghaith
2   College of Medicine, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
,
Khalid AlOsaimi
2   College of Medicine, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
,
Lulu Aldhwaihy
3   Department of Otolaryngology, Head & Neck Surgery, Security Forces Hospital in Riyadh, Riyadh, Riyadh Province, Saudi Arabia
,
Alaa Baghazal
4   Department of Ophthalmology, AlSalamah Hospital, Jeddah, Makkah Province, Saudi Arabia
,
Hassan Bogari
5   College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Makkah Province, Saudi Arabia
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Abstract

5-Fluorouracil (5-FU) is an antimetabolite that inhibits fibroblast proliferation and collagen synthesis, making it valuable in facial plastic surgery for scar modulation and other conditions. This systematic review examines the indications, outcomes, and safety of 5-FU in facial plastic surgery. Due to methodological heterogeneity across studies, a narrative synthesis was performed. A comprehensive search of MEDLINE, Cochrane, SCOPUS, EMBASE, PubMed, and Web of Science identified 32 eligible studies (1,456 patients) from 4,772 screened articles. Indications included keloids, hypertrophic scars, contractures, periocular scars, granulomas from filler complications, nasal skin thickening, infections following thread lifts, resistant facial warts, and hypochromic lesions. Most studies reported reductions in scar size, erythema, and recurrence rates, with combination therapies enhancing outcomes. Adverse effects were mild and transient. However, variability in dosing, administration frequency, and follow-up underscores the need for standardized treatment guidelines and long-term studies.

Keywords

5-Fluorouracil - scar management - facial plastic surgery - intralesional therapy - combination therapy


Publikationsverlauf

Accepted Manuscript online:
18. Februar 2025

Artikel online veröffentlicht:
05. März 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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