Rhinophyma

A 61-year-old patient was referred to the Rhinology clinic to discuss about treatment options for his rhinophyma. He did not receive any previous therapy and the deformity of the nose has progressively deteriorated, having a negative impact on his confidence and social life. He did not have any other dermatological problems and was on Warfarin for Atrial Fibrilation. After discussion about the surgical treatment, pre-operative photographs were taken (Fig. 29.1) and warfarin was switched to LMWH, during the perioperative period during the local protocol. He underwent a microdebrider-assisted rhinophyma excision and biopsies were taken to exclude any skin malignancy (Fig. 29.2). The wound was left to heal by secondary intention and was covered with non-adhesive dressings and antibiotic ointment. He was reviewed regularly (weekly for the first 4 weeks) in order to assess the wound healing and exclude any wound infection. The cosmetic result was satisfactory, and no more revision surgeries were required.