Rhinophyma Surgery Procedure

Rhinophyma is an uncommon skin condition. Its is due to the skin of the tip of the nose becoming thicker and thicker and thicker until it causes the nose to become deformed. It takes many years to develop, so its usually not until the late fifth or sixth decade of life before it becomes a problem. It is instantly recognizable, as there are very few other medical conditions which can make the nose  appear this way. The changes are due to both enlargement and engorgement of the blood vessels along with the skin oil glands massively enlarging. Initially the blood vessels are affected and call flushing. At this stage, it is known as Rosacea. Later the skin glands swell and the condition develops into rhinophyma. Doctors believe it is the extreme form of the common skin condition called Rosacea. This causes the skin to be red and flushed in the areas of the nose and cheeks. With time some people also develop swollen skin glands which results in the thick deformed skin.

Common dust mites are thought to be the inciting cause. Not that the skin condition is an infection, the skin always has bacteria and fungi residing on it. However the skin’s reaction is believed to be the cause. Rhinophyma was known for many years as ‘rum nose, brandy nose, hammer nose, copper nose, potato nose, rum-blossom, toper’s nose’, but there isn’t any evidence alcohol is involved and the terms are no longer appropriate. There have been many famous people with the condition, C.W. Fields is a well known example. Former president Bill Clinton appears to possibly be developing the condition too. There is no medical treatment known to work. Surgery alone is the treatment when the skin becomes so thickened something has to be done. Rhinophyma surgery is truly a sculpting of the nose as the thickened skin is pared down to the overlying cartilage and bone. This allows the true shape of the nose to again be revealed. There is ongoing debate as to the best method to shave the skin down. The choices are ‘cold steel’, cautery, laser, coblation and diathermy.

The reality is the method isn’t the most important factor, the experience of the surgeon is. As the condition is rare, few surgeons have the chance to develop expertise in rhinophyma surgery. The open skin wound remains raw until the skin can grow out from the remaining skin glands and recover the nose again. This takes two or three weeks. During this time the nose is crusty red and swollen. However it often looks immediately better than before the rhinophyma surgery, in spite of the raw exposed skin. The post operative recovery is surprisingly not painful as most of the tiny skin nerves have been cut during the surgery. The skin is very traumatized and takes many months to settle and the redness and swelling to resolve. Rhinophyma surgery is very successful and its rare for someone not to be satisfied they went ahead. This type of rhinoplasty, rhinophyma surgery, is usually covered by the Ontario Health Insurance Plan.

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