Rhinophyma treatment options refer to any method aimed to address enlarged sebaceous glands and connective tissues. Rhinophyma nose treatment involves removal of diseased skin and improvement of the appearance of the nose.
Dr. Gary Linkov is a board-certified plastic surgeon in New York who offers cosmetic treatments for rhinophyma to create a more pleasing shape to the nose. Dr. Linkov at City Facial Plastics in Manhattan, NY will assess the damage to the nose and offer nose plastic surgery solutions to improve the form and function for patients with rhinophyma.
What Is Rhinophyma Treatment?
Once a rhinophyma is identified, treatment options should be thoroughly discussed. These include:
- Observation (no treatment)
- Isotretinoin – oral medication used for an early-stage disease to lower sebum production and sebaceous gland size
- Topical metronidazole – decreases skin inflammation
- Cold knife
- Laser (CO2)
Rhinophyma is a disease of the nose and surrounding skin that is found primarily in men. It begins later in life (after age 50) and causes enlarged sebaceous glands and connective tissue. The effects on the nose can be quite disfiguring and may cause nasal obstruction. Often people live with rhinophyma without realizing that there are treatment options that could help them look and feel better. It used to be thought that rhinophyma was due to excessive alcohol intake, but now we know that the precursor condition is actually rosacea.
What Are the Causes of Rhinophyma?
Rhinophyma is not a common issue. The most susceptible population for this skin condition is fair-complexioned ethnicities, and men are more likely to have rhinophyma than women. There is not a known cause for rhinophyma.
The myth that it is caused by heavy alcohol consumption is unfounded, as there is no link to rhinophyma and alcohol use. Those with acne rosacea are more likely to also have rhinophyma. Early symptoms include thick, waxy skin on the nose tip that is red and rough. The nose tip can begin looking larger or bulbous with more visible pores.
Who Is a Good Candidate for Rhinophyma Treatment?
A good candidate for nose rhinophyma treatment has one or more of the following situations, including:
- Nasal obstruction due to external nasal valve collapse
- Enlarged nodular areas along the nasal bridge, tip, and ala
- Areas of concern within the nodular areas for skin cancer
- Psychological distress from rhinophyma
How Is Rhinophyma Surgery Treatment Done?
Dr. Linkov prefers to combine surgical treatment modalities, offering a cautery approach to debulk the nodularity first and then fine tune it with CO2 laser.
A summary of the surgical steps are included below:
- Local anesthesia – 1% lidocaine with 1:100,000 epi is used to infiltrate the nasal soft tissue envelope. Titanium corneal shields are carefully inserted to protect the eyes. The patient is then prepped and draped in the usual sterile fashion.
- Cautery – First, a loop tip cautery is used to excise and ablate the rhinophymatous tissue along the nasal dorsum, sidewalls, ala, and tip. The alar margin is not cauterized to prevent scarring. Once an adequate amount of the rhinophymatous tissue is removed, based on palpating the thickness and quality of the remaining tissue, and hemostasis is confirmed, we then switch to the CO2 laser.
- Laser – Once the laser settings are entered, the laser is used to ablate the remaining portion of the lesion in a paintbrush fashion to the appropriate depth. The carbonaceous debris and char are removed.
- Dressing – Aquaphor ointment is liberally applied to the ablated areas, and covered with telfa and tape.
How to Prepare for Rhinophyma Treatment?
Once you have decided to undergo rhinophyma treatment surgery at City Facial Plastics in NYC, Dr. Linkov will discuss in detail how to prepare for your surgery.
There are a few steps you should take before your rhinophyma nose treatment surgery to get the best results. These steps include:
- You must be off oral isotretinoin for at least 6 months before surgery as it can prevent reepithelialization (new skin growth)
- Avoiding certain medications and supplements that may thin the blood, such as:
- NSAIDS – ibuprofen (Motrin) and naproxen
- Vitamin E
- Garlic, Ginger, Ginseng, St. John’s Wort, Ginkgo, Black Cohosh
- Stop smoking at least 2 weeks before surgery, as tobacco products can decrease blood flow to the skin and compromise the healing of the surgical site
- Pick up medications at the pharmacy, as you will be prescribed certain medications to take after surgery, such as:
- An antibiotic
- Pain medication
- Identify an escort home, as you will need someone to accompany you home and stay with you at least the first night
What to Expect on the Day of the Procedure?
On the day of your nose rhinophyma treatment surgery at City Facial Plastics in UES, Manhattan, it is important not to eat or drink 6 hours before your surgery, as you will receive IV sedation.
Most rhinophyma removal treatment surgery is performed under deep anesthesia with an anesthesiologist, so there will be no pain during the surgery and you will have no recollection of the procedure. The intake process can take about an hour, the surgery usually takes 2 hours, and recovery will be about another hour.
What Is the Recovery From Rhinophyma Treatment?
Complete re-epithelialization (new skin growth) is expected to occur within about three weeks. During this time, the treated areas should be cleaned with a vinegar mixture several times a day and covered with non-antibiotic ointment (such as Aquaphor). Sun exposure should be avoided for 2-3 months, until all the redness subsides, to prevent hyperpigmentation. Avoid antibiotic ointments if possible to prevent contact dermatitis (rash and increased redness).
What Are the Risks and Complications of Rhinophyma Treatment?
The risks and complications of rhinophyma treatment include:
- Poor scarring
- Undesirable aesthetic result
- Alar retraction
- Persistent nasal valve collapse (nasal obstruction)
Are Patients Satisfied After Rhinophyma Treatment?
Nasal breathing and nasal appearance are important quality of life factors for many people. Nose rhinophyma treatment can improve both leading to high levels of patient satisfaction. Attention must be paid to remove the rhinophyma while carefully preserving the underlying structural components, such as cartilage. Dr. Linkov performs many cosmetic rhinoplasty procedures and always factors in the aesthetics when offering rhinophyma laser treatment surgery.
Will Insurance Cover Rhinophyma Treatment?
Most functional (nasal obstruction) rhinophyma surgeries are covered by insurance. A rhinophyma nose treatment done purely for cosmetic purposes is generally not covered by insurance. Keep in mind that some surgeons may not accept in-network insurance.
In these situations, a cost that includes the surgeon’s fee, facility fee, and anesthesia fee is calculated based on the complexity of the surgical treatment for rhinophyma and communicated to the patient before surgery is scheduled. Make sure to check in with your insurance carrier if planning to undergo rhinophyma surgery treatment.
How to Find the Best Rhinophyma Treatment Near Me?
Dr. Gary Linkov is a board-certified facial plastic surgeon in Manhattan, NYC specializing in nasal surgery. Dr. Linkov is the best specialist with extensive experience treating all conditions of the nose. He is the Chief of Otolaryngology and Facial Plastic Surgery for the Veterans Hospital in Brooklyn, NY, where he operates on complex nasal deformities on our country’s veterans. Dr. Linkov’s private practice in Manhattan’s Upper East Side focuses on cosmetic and functional rhinoplasty, as well as rhinophyma surgery.
Rhinophyma Treatment Before and After
If you have rhinophyma and want to explore treatment options to improve the appearance of your nose, contact City Facial Plastics in Midtown, Manhattan today. We will schedule your consultation with the best-in-class facial plastic surgeon in New York City Dr. Gary Linkov to discuss treatments available for rhinophyma.