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Rhinophyma

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Rhinophyma

Rhinophyma is a condition of very marked overgrowth (hyperplasia) of the sebaceous glands of the nose. The condition is part of the common skin disease known as rosacea. Rosacea is a chronic acneform disorder of the pilosebaceous units of the skin coupled with an increase in the reactivity of the local skin capillary beds to heat. Where women commonly suffer from one of three stages of rosacea, men more typically suffer the associated nasal overgrowth (rhinophyma). The sensitivity of the capillaries in women results in flushing and finally series of dilated small red veins visible at the surface of the skin.

Rosacea typically affects Celtic people and southern Italians, both with fair skin types. Individuals with brown or black skin are affected much less commonly. Patients are typically 20-70 years old at onset of the disease.

Patients may describe sensitivities to extremes of temperature, hot liquids, alcohol, spicy foods or working in the direct sunlight. Typically these symptoms of aggravation are more typical in the female rosacea patient than in the male with rhinophyma. Although alcohol may be a precipitating factor or trigger for rosacea, the stigmata that all patients with the large overgrown nose seen in rhinophyma are in fact alcoholics is absolutely wrong.

The sebaceous glands that are typically overgrown in rhinophyma are regular skin glands that occur in all area of our skin with the exception of the soles and palms. These glands produce an oily substance called sebum, a composition of fat and debris from dead fat-producing cells. The product is designed to lubricate skin in non-hair bearing skin and the hair shaft itself in hair bearing skin. The sebum is brought to the surface of the skin through ducts. Excess sebum production can occur in response to poor hygiene, diets rich in fat, in conditions of accelerated glandular activity (like rosacea/rhinophyma) and naturally during adolescence.

Treatment of rhinophyma may include avoiding the many triggers for rosacea and may combine a medical based therapy to control the existing rosacea but typically involves a surgical external nasal reshaping.

THE PROCEDURE:

Nasal reshaping involves shaving away the excess nasal glandular overgrowth to achieve an aesthetically pleasing nasal shape. The wound surface is then allowed to re-heal by a process termed re-epithelialization. Careful attention is made to leave enough skin adnexal structures available at the wound base to allow for proper re-healing. Scalpel, dermabrasion, electrocautery, CO2 laser or a combination of these methods can be used for nasal reshaping. All methods produce similar results.

At the completion of the procedure, bleeding vessels are controlled and an ointment based dressing is applied to the wound.

Recovery:            

The typical convalescence following rhinophyma surgery is approximately 3-4 weeks. Ointment and bandage dressings are used for the first 2-3 weeks. Pain is controlled with prescription medications for the first few days. Most patients require only over-the-counter medications or are comfortable without pain medication within days of the procedure.

For a more detailed discussion on expected results, recovery, and specific complications, please see Dr. Diaz for your consultation.