Electro-rhinosculpture for the surgical management of rhinophyma.

None of the authors have any commercial associations or financial disclosures that might pose or create a conflict of interest.

We describe a simple technique for excision of rhinophyma using equipment found commonly in theatre. The nose is infiltrated with lignocaine and adrenaline, and a colposcopic loop electrode (15mm disposable loop electrode; Meditech, Shaftesbury, UK) is used to shave excess tissue in smooth planes while providing simultaneous haemostasis. The burr (6mm Bud Trimmer Burr; Mercian, Bromsgrove, UK) is then used to soften the nasal contours into the desired appearance. Additional haemostasis is performed with loop diathermy before the wound is dressed.

Excision of rhinophyma is typically a bloody and time consuming affair. Our technique creates a smoothly contoured appearance and simultaneous haemostasis with only a few passes of the loop cautery tip.

Disposable loop electrode. (Meditech, 15mm) and Bud Trimmer Burr (Mercian Surgical Ltd, 6.0mm with Aesculap Drill System)

Demonstration of use of colposcopic loop cautery

Pre-op (left), immediately post-op (centre) and 6 weeks post-op (right) lateral views