Rhinophyma Excision
What is Rhinophyma?
Rhinophyma is a disfiguring deformity of the nose caused by the growth of sebaceous (oil) glands and the surrounding soft tissue. Rosacea is a pre-cursor condition to rhinophyma, though having rosacea does not mean a patient will develop rhinophyma. And while rosacea responds well to medical treatment, treating rosacea does not necessarily prevent the development of rhinophyma in susceptible individuals. Rosacea is more common in Caucasian females, while rhinophyma occurs 5 to 30 times more frequently in Caucasian males, leading to the belief that there is an androgenic (i.e. testosterone) influence on its development. There have been a few case reports of Asian and African American patients developing rhinophyma, but it is very uncommon.
As rhinophyma progresses it can be disfiguring, leading to psychological distress for the patient. As the oil glands grow their drainage can become blocked off, leading to infections of the area. The rhinophymatous tissue can also enlarge to the point that it causes difficulty breathing through the nose
How is Rhinophyma Treated?
Treatment of rhinophyma is via excision. Multiple methods have been described over the years, including using lasers, dermabrasion, and surgical excision via a scalpel. While some providers recommend excision of all of the tissue containing oil glands and repairing with a skin graft or flap, Dr. Sowder has found that technique causes a mismatch in the color of the skin or more noticeable scars. He prefers to excise the bulk of the tissue using an electrocautery device to prevent bleeding, leaving a small layer of the normal sebaceous tissue over the nasal structure. This tissue has a tremendous ability to grow new, healthy skin over the treatment area that looks much more similar to the surrounding skin. Most patients tolerate this procedure very well while awake, using just numbing medication (local anesthesia) over the treatment area. Some patients require several procedures to get the best result.
What to Avoid Before Surgery
To ensure optimal surgical results and minimize the risk of complications, it is crucial to avoid all blood thinning medications and supplements for at least two weeks prior to your facelift procedure. This includes aspirin or aspirin-containing products, as well as anti-inflammatory drugs such as ibuprofen or naproxen (including Motrin, Aleve, and Advil). Additionally, supplements such as Vitamin E, multivitamins, and omega 3 fatty acids (fish oil and flaxseed oil) should be avoided. For a complete list of medications and supplements to avoid, please consult with your pre-op nurse. Our goal is to help you achieve the best possible results while ensuring your safety and comfort throughout the surgical process.
What can I expect in Recovery
Because we do not repair excised area with skin grafts or flaps, wound care in the weeks following the procedure is paramount to ensure optimal healing. After surgery, the nose is coated in antibiotic ointment and covered with an absorbable mesh that prevents bleeding. The patient is to keep the nose coated with Aquaphor ointment (like frosting a cupcake) at all times for the first 2 to 3 weeks after surgery. Starting the day after surgery, you will wash the treated area morning and night with a gentle facial cleanser (such as CeraVe or Alastin Gentle Cleanser), pat dry, and immediately cover with Aquaphor again. In order to keep the surgery site clean you must avoid any strenuous activity or sweating for 2-3 weeks. Dr. Sowder will see you back in follow-up periodically after surgery to ensure appropriate healing. Final results may take several months as swelling and redness gradually subside.