Tangential Excision of Rhinophyma with the Disposable Razor Blade: Simple and Cost Efficient with Aesthetically Good Results

Marcus Vishal Kiehlmann; Evi M Morandi; Shafreena Kühn; Stefano Spennato; Torsten Schloßhauer; Gabriel Djedovic; Ulrich M Rieger

doi:10.4103/JCAS.JCAS_139_20

Tangential Excision of Rhinophyma with the Disposable Razor Blade: Simple and Cost Efficient with Aesthetically Good Results

J Cutan Aesthet Surg. 2021 Jan-Mar;14(1):72-76. doi: 10.4103/JCAS.JCAS_139_20.

Authors

Marcus Vishal Kiehlmann¹, Evi M Morandi², Shafreena Kühn¹, Stefano Spennato¹, Torsten Schloßhauer³, Gabriel Djedovic⁴, Ulrich M Rieger¹

Affiliations

¹ Department of Plastic and Aesthetic Surgery, Reconstructive and Hand Surgery, AGAPLESION Markus Hospital Frankfurt, Frankfurt am Main, Germany.
² Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Innsbruck, Austria.
³ Department of Plastic, Aesthetic, Reconstructive and Hand Surgery, AGAPLESION Ev. Hospital Mittelhessen, Gießen, Germany.
⁴ Department of Plastic, Reconstructive and Aesthetic Surgery, Academic Hospital, Feldkirch, Austria.

Abstract

Medical therapies for rhinophyma have been described but these only delay progression. Therefore, surgery is the method of choice. Plenty of modalities have been described including cold-knife surgery, electrosurgery, hydrosurgery, laser-assisted treatments, and dermabrasion.

Settings and design: In this two-center study, patients' charts and photodocumentation were analyzed retrospectively.

Materials and methods: Surgery was performed under general anesthesia with an additional local anesthesia of the affected areas of the nose. We removed the hypertrophic tissue in thin layers with a sterile disposable razor blade under constant visual control of the underlying cartilage and adnexal structures. A dressing with Mepithel and gauzes was applied. Patients presented weekly to monitor the wounds. Follow-up was 1 year.

Results: From 2016 to 2019, nine male patients with rhinophyma underwent surgical therapy at AGAPLESION Markus Hospital, Frankfurt am Main, Germany and at the Department of Plastic, Reconstructive and Aesthetic Surgery, Innsbruck Medical University, Austria. The mean age of the patients was 66 years. Mean time to complete re-epithelization equaled 31.5 days. No recurrences were noted within the follow-up period of 1 year. Patients' satisfaction was very high. Only one patient had hypertrophic scars at the wing of the nose and another one developed a superficial fistula without connection to the nasal cavity.

Conclusion: To the best of our knowledge, this is the first case series describing the use of a disposable razor blade for rhinophyma treatment supporting its efficiency described in previous anecdotal publications. We can highly recommend the technique, as it is cost-efficient and simple and provides excellent aesthetic results.

Keywords: Razor blade; Rhinophyma is a benign disease that afflicts mostly males in their 50th–70th decade. Surgical therapy in rhinophyma includes various techniques and devices. We would like to report on our experience with the tangential excision with a disposable razor blade. Nine patients were treated within 3 years. The use of a disposable razor blade in the surgical treatment of rhinophyma is inexpensive, easy, and yields excellent aesthetic results.; rhinophyma; tangential excision.