Aesthetic Plastic Surgery

, Volume 37, Issue 1, pp 125–127 | Cite as

Optimizing Cosmesis with Conservative Surgical Excision in a Giant Rhinophyma

  • Davide Lazzeri
  • Tommaso Agostini
  • Giuseppe Spinelli
Case Report General Reconstruction


Rhinophyma is considered the end stage in the development of rosacea, with a clinical aspect characterized by sebaceous hyperplasia, fibrosis, follicular plugging, and telangiectasia. Although the treatment of rhinophyma typically has an aesthetic purpose, in some cases it also can help with nasal obstruction and eating difficulties caused by rhinophyma beyond the abnormal physical appearance that can cause social seclusion. Very few giant rhinophymas have been reported in the literature. In most cases full-thickness excision of the rhinophymatous tissue down to perichondrium and periosteum of the nasal osteocartilaginous framework followed by coverage of the residual defect with a full-thickness skin graft or local flap has been described in patients affected by giant rhinophyma. The poor results of this approach encouraged us to manage conservatively a very severe form of rhinophyma. We describe the case of a 62-year-old man who presented with a 12-year history of a progressively growing mass on the nose and with a history of nasal obstruction and eating difficulties. We advocate a careful tangential excision of the rhinophymatous tissue which allows the residual deep pilosebaceous appendages to reepithelialize as a safe method and provides a good cosmetic result with minimal scarring. To our knowledge this is the first case of a giant rhinophyma treated with conservative excision followed by secondary healing.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Giant rhinophyma Rosacea Conservative excision Secondary-intention healing 


Conflict of interest

None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this article.


  1. 1.
    Rohrich RJ, Griffin JR, Adams WP Jr (2002) Rhinophyma review and update. Plast Reconstr Surg 110(3):860–869PubMedCrossRefGoogle Scholar
  2. 2.
    Curnier A, Choudhary S (2004) Rhinophyma: dispelling the myths. Plast Reconstr Surg 114(2):351–354PubMedCrossRefGoogle Scholar
  3. 3.
    Aloi F, Tomasini C, Soro E, Pippione M (2000) The clinicopathologic spectrum of rhinophyma. J Am Acad Dermatol 42(3):468–472PubMedCrossRefGoogle Scholar
  4. 4.
    Mangal M, Agarwal A, Jain H, Gupta A (2012) Giant rhinophyma of the nose. J Oral Maxillofac Surg 70(2):376–377PubMedCrossRefGoogle Scholar
  5. 5.
    Akhdari N, Ettalbi S, Rachid M, Amal S (2009) Rhinophyma: a giant presentation. Clin Exp Dermatol 34(4):536–537PubMedCrossRefGoogle Scholar
  6. 6.
    Köse R, Okur MI, Güldür ME (2008) Giant rhinophyma in a bronchial asthma patient treated by excision and full thickness skin grafting. Dermatol Online J 14(9):9PubMedGoogle Scholar
  7. 7.
    Lazzeri D, Colizzi L, Licata G et al (2012) Malignancies within rhinophyma: report of three new cases and review of the literature. Aesthetic Plast Surg 36(2):396–405PubMedCrossRefGoogle Scholar
  8. 8.
    Chatelain R, Bell SA, Konz B, Röcken M (1998) Granuloma eosinophilicum faciei simulating rhinophyma: therapeutic long-term outcome after surgical intervention. Hautarzt 49(6):496–498PubMedCrossRefGoogle Scholar
  9. 9.
    Leonard AL (2003) A case of sarcoidosis mimicking rhinophyma. J Drugs Dermatol 2(3):333–334PubMedGoogle Scholar
  10. 10.
    Nesi R, Lynfield Y (1996) Rhinophymalike metastatic carcinoma. Cutis 57(1):33–36PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2013

Authors and Affiliations

  • Davide Lazzeri
    • 1
  • Tommaso Agostini
    • 2
  • Giuseppe Spinelli
    • 2
  1. 1.Operative Unit of Plastic and Reconstructive SurgeryHospital of PisaPisaItaly
  2. 2.Maxillofacial Surgery UnitHospital of FlorenceFlorenceItaly

Personalised recommendations