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

Abstract

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

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Keywords

Giant rhinophyma Rosacea Conservative excision Secondary-intention healing 

Notes

Conflict of interest

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

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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

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