A Case of Giant Rhinophyma Showing Difficulty in Nasal Respiration

ABSTRACT

Rhinophyma is characterized by a disfiguring soft tissue hypertrophy of the nose. Severe cosmetic deformity and impairment of breathing may coexist, making the surgical treatment necessary. We present a case of giant rhinophyma, who had difficulty in nasal breathing and took preventive aspirin for CVA. We treated this patient with scalpel tangential excision and skin graft. A giant rhinophyma involved two thirds of nasal dorsum, nasal tip, and both alae. The patient withdrew aspirin 7 days prior to surgery, and rhinophyma was excised with scalpel. The defect was covered with full-thickness skin graft from right supraclavicular area. Five days after surgery, the patient resumed to take aspirin. A skin graft was taken completely and a pathologist confirmed an excised specimen to be a rhinophyma. Within 1 month postoperatively, the patient showed more natural nasal contour and improvement of nasal respiration. Six months after the operation, the nose represented a good appearance without recurrence of rhinophyma. We present a case of giant rhinophyma which had bleeding tendency because of preventive aspirin. We treated this case with scalpel excision and full-thickness skin graft, instead of secondary intention wound healing.