Surgical Management of Moderate Rhinophyma with Nasal Nodules: An Electrosurgery Approach

Introduction: Rhinophyma, a severe manifestation of rosacea, is characterized by hypertrophy of sebaceous glands and fibrosis of the nose, often leading to significant aesthetic and functional impairments. Surgical treatment is the preferred approach for advanced cases to restore nasal appearance and function. Case Report: We present the case of a 60-year-old man with moderate rhinophyma and nodules on the nostrils. Surgical management under local anesthesia involved the use of thermal loops for excision of the lesions and bipolar electrosurgery for hemostasis. The patient was also treated for rosacea with topical agents, including metronidazole and azelaic acid, and oral doxycycline for inflammatory lesions. Directed healing followed the surgery, along with LED phototherapy and ablative erbium laser sessions to optimize results. Discussion: The use of thermal loops and electrosurgery allowed for precise excision and control of bleeding. Postoperative care, including daily greasy vaseline dressings, facilitated rapid healing. Mild infection at the excision sites was treated with topical and prophylactic antibiotics. Six sessions of LED therapy combining four types of light (infrared, red, yellow, and blue) improved healing and reduced inflammation. Ablative erbium laser was proposed to further enhance the aesthetic outcome. Conclusion: A combined surgical approach and careful postoperative management yielded satisfactory results in the treatment of rhinophyma.