Reconstruction of Nasal Defect Caused by Rhinophyma with Excision and Full Thickness Skin Graft: A Case Report

Abstract: Rhinophyma is a benign hypertrophic thickening and edema of the nasal pyramid skin caused by the growth of sebaceous glands, underlying connective tissue, and blood vessels. It is a fairly uncommon nasal disorder, affecting the nasal soft tissues and leading to nasal architecture disturbance, airway obstruction, and nasal aesthetic unit deformity. In cases of severe rhinophyma, surgical management is the first line of treatment, and full thickness skin graft (FTSG) is an additional option. This paper reports a nasal reconstruction with excision of rhinophyma, followed by FTSG as a defect reconstruction in Manado. A 53-year-old man complained about breathing, feeding, and nasal deformity problems for the last three years. About 25 years ago, the patient initially noticed a slowly thickening of the nose skin. Patient works for the army and gets a lot of sun exposure. Its bulk at presentation obstructed the nares (stage IV of rosacea) and insulted the appearance. The patient underwent surgical excision with a knife to shave off the aberrant tissue, with electrocauterization of the bleeding spots, followed by a FTSG from the left retroauricular as a donor site to cover the defect with good result. The diagnosis of rhinophyma was validated by histological analysis of the specimens. In conclusion, rhinophyma representing stage IV of rosacea, gives the nose and the rest of the face an unsightly appearance. It can be effectively treated with surgical excision and FTSG. Postoperative follow-up and supervision are necessary to ensure the optimal healing outcomes and that the patient is more confident with the result in concerns with functionality as well as appearance. Keywords: rhinophyma; nasal defect reconstruction; full-thickness skin graft