Methods and complications of rhinophyma excision.

For years cosmetic surgeons have sought methods of treatment of large rhinophyma. These include creation of flaps with excision of excess skin, dermabrasion, free-hand shave, and others. The CO2 laser has been used by itself, or in combination with other methods to vaporize the rhinophyma. Advantages of the the laser include hemostasis, better view of the tissues, thin layer-by-layer removal of the hyperplastic sebaceous glands, and careful shaping of the resection edges. Disadvantages include risk of facial burns and overabundant removal of tissue with cartilage exposure. We present a case of rhinophyma excision using the CO2 laser and the complication of excessive vaporization of the sebaceous tissue. Included is a discussion of other complications of laser excision of rhinophyma, possible methods of reconstruction, and a literature review.