The subunit method: A novel excisional approach for rhinophyma

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Presentation transcript:

The subunit method: A novel excisional approach for rhinophyma Aladdin H. Hassanein, MD, MMSc, Edward J. Caterson, MD, PhD, Jessica Erdmann-Sager, MD, Julian J. Pribaz, MD Journal of the American Academy of Dermatology Volume 74, Issue 6, Pages 1276-1278 (June 2016) DOI: 10.1016/j.jaad.2016.01.004 Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 A 34-year-old male with rhinophyma. A, Prior to onset of disease; B, Presentation at clinic with phymatous dorsum, tip, sidewalls, and alae which have effaced tip definition; C, Enlarged nasal tip on basal view. Note representation of columellar artery perfusing the soft triangle/columella/tip flap; D, 6 subunit flaps elevated to expose sebaceous hypertrophy; E, Basal view shows improved tip shape; F, Postoperative appearance 4 months later. Note scars at subunit junctions are well-concealed. Nasal contour and tip definition are restored. Journal of the American Academy of Dermatology 2016 74, 1276-1278DOI: (10.1016/j.jaad.2016.01.004) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 The subunit approach for rhinophyma in a 66-year-old male who previously underwent tangential excision. A, Preoperative image; B, Basal view. Note external valve collapse from destruction of support; C, Assessment of alar subunits on lateral view exhibit cobblestoning with poor skin quality; D, Subunit flaps raised. Entire alar subunits excised because of disease involvement; E, Alar subunits completely replaced with full-thickness skin graft. The other subunits were redraped with native skin flaps; F, Basal view 11 months postoperatively shows alar batten grafts from auricular conchal cartilage have restored external nasal valves; G, Lateral view exhibits improved contour. Skin grafted alar subunits are well camaflouged; H, Frontal view. Scars on subunit borders are aesthetically advantageous. Journal of the American Academy of Dermatology 2016 74, 1276-1278DOI: (10.1016/j.jaad.2016.01.004) Copyright © 2016 American Academy of Dermatology, Inc. Terms and Conditions