CC BY-NC 4.0 · Arch Plast Surg 2018; 45(05): 490-492
DOI: 10.5999/aps.2017.01452
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An old problem with a new solution: Cost-effective, easy correction of rhinophyma using a disposable razor

Evi M. Morandi
Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria
,
Ralph Verstappen
Department of Plastic, Reconstructive and Hand Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
,
Julia Metzler
Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria
,
Peter Kronberger
Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria
,
Gerhard Pierer
Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria
,
Gabriel Djedovic
Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria
› Author Affiliations

Rhinophyma is the late stage of rosacea, a chronic skin disorder that is characterized by distorting hypertrophy of the sebaceous glands and has been mistakenly connected to alcohol abuse [1], making it a socially stigmatized condition. While patients seek treatment mainly for cosmetic reasons, cases of malignant degeneration have been reported [2]. The treatment of rosacea includes rigorous avoidance of triggers, antibiotics, and retinoids. The mainstay of the treatment of rhinophyma consists of surgery, using a CO2 laser, hydrosurgery, or simple excision. We report the case of a 55-year-old female patient who presented with a case of distorting rhinophyma ([Fig. 1]) after undergoing conservative treatment with oral isotretinoin and ivermectin without any improvement. Tangential excision was performed using a commercially available, sterile single-blade razor ([Fig. 2]). Wound dressings using Mepithel (Mölnlycke Health Care, Goeteborg, Sweden) were applied postoperatively. The final aesthetic outcome 10 months postoperatively was pleasing, and the patient’s postoperative course was uneventful. No further corrections were needed. The nose regained a natural contour ([Fig. 3]). Despite the manifold technologies available for the treatment of rhinophyma, there is no consensus on the best technique. The feasibility of obtaining appropriate histopathological samples is the main advantage of tangential excisional techniques. In such techniques, it is crucial to leave the lower part of the pilosebaceous units intact by careful, step-by-step shaving to guarantee total excision along with undisturbed healing by secondary intention. A sterile, disposable razor is a valuable tool in rhinophyma surgery that is inexpensive, commercially available, and easy to use. This method has been described before [3], but it has largely been forgotten and is not in routine clinical use. Thus, we herein re-describe and recommend this cost-effective technique that unites the advantages of excisional and tangential ablative methods in a single simple-to-perform procedure.

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Fig. 1. Preoperative lateral (A) and frontal (B) standardized photographs of the patient.
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Fig. 2. Intraoperative view of the patient (A) operated on with a sterile disposable razor (B).
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Fig. 3. Lateral (A) and frontal (B) photographs of the patient 10 months postoperatively.

NOTES

Ethical approval

The study was performed in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained.


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Patient consent

The patient provided written informed consent for the publication and the use of her images.


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Publication History

Received: 05 September 2017

Accepted: 08 February 2018

Article published online:
03 April 2022

© 2018. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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