Patient - Reconstruction

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Before

This gentleman came to see me because of a scar on his nose from Mohs excision of a squamous cell cancer by a dermatologist. He was not happy with the scar and his wife, who is a former patient of mine, suggested he come see me. When I examined him, he had a flattened scar that was quite obvious. More striking to me was his rhinophyma. This is a condition seen mostly in older men. The cause is poorly understood, but it results in overgrowth of the oil glands in the skin of the nose. This can cause massive growth of nasal skin resulting in disfiguring deformities. It is sometimes mistakenly attributed to alcohol abuse, but this is not the case. The usual treatment is to shave down the skin, a procedure called dermaplaning, using an electric wire loop cautery tip. The raw surface is then re-populated with skin cells growing out of the pores in the nose.

After

He is shown 5 weeks out after the nose is fully healed. The condition can recur, but usually does so slowly and it is uncommon for patients to have to undergo the surgery more than once. Notice how reshaping the nose helped the scar a great deal as well. The improvement in the shape of his nose is especially well seen from below, in what is called a “worm’s eye” view.