title: Surgical correction of rhinophyma: comparison of two methods in a 15-year-long experience.
abstract: OBJECTIVE
  Rhinophyma is characterized by slowly progressive tumour-like enlargement of the nasal skin that will not resolve spontaneously. Though its treatment consists of surgical removal of the hyperplastic alterations, in the literature there is not general agreement about the best method. We presented our experience with two different treatment modalities such as decortication by scalpel and CO2 laser treatment.
  
  
  METHODS
  The authors reviewed the long-term results of 67 patients affected by rhinophyma treated with two different methods between 1996 and 2011. Outcomes were determined by case notes, clinical review and patient satisfaction questionnaire.
  
  
  RESULTS
  Forty-five cases were treated with tangential excision and 22 with a CO2 laser. Minor complications, including scarring and hypopigmentation, were seen in 6 patients. All patients were satisfied with their outcomes at the follow-up visit, and no major complications were detected during follow-up.
  
  
  CONCLUSIONS
  Both tangential excision and carbon dioxide laser are well-established, reliable procedures for rhinophymaplasty that preserve the underlying sebaceous gland fundi allowing spontaneous re-epithelialization without scarring with similar outcomes and high patient satisfaction. The original nose shape and nearly normal skin surface texture are preserved by quickly removal of the hypertrophic tissue sparing the pilosebaceous tissue. The CO2 laser is more capital intensive and results in higher fees compared with the simpler cold blade tangential excision. In our experience the ease of use, accuracy and precision of the lasers offer is not justified by the increased costs.
authors.affiliation: Plastic and Reconstructive Surgery Unit, Hospital of Pisa, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Lazzeri
authors.forename: Lorenz
authors.initials: L
authors.lastname: Larcher
authors.forename: Georg M
authors.initials: GM
authors.lastname: Huemer
authors.forename: Stefan
authors.initials: S
authors.lastname: Riml
authors.forename: Luca
authors.initials: L
authors.lastname: Grassetti
authors.forename: Marcello
authors.initials: M
authors.lastname: Pantaloni
authors.forename: Qingfeng
authors.initials: Q
authors.lastname: Li
authors.forename: Yi Xin
authors.initials: YX
authors.lastname: Zhang
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Spinelli
authors.forename: Tommaso
authors.initials: T
authors.lastname: Agostini
mesh_terms: D000368:Aged; D002921:Cicatrix / Q000209:etiology; D062109:Dermatologic Surgical Procedures / Q000295:instrumentation; D005500:Follow-Up Studies; D006801:Humans; D017496:Hypopigmentation / Q000209:etiology; D053685:Laser Therapy / Q000379:methods; D054020:Lasers, Gas / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000601:surgery; D017060:Patient Satisfaction; D011183:Postoperative Complications; D062326:Re-Epithelialization; D012189:Retrospective Studies; D012224:Rhinophyma / Q000145:classification / Q000601:surgery*; D016896:Treatment Outcome