A new surgical approach for the treatment of Rhinophyma.

BACKGROUND: Rhinophyma is a rare and benign pathological condition affecting the nose. It can be localized or generalized causing a nasal deformity, mainly of the lower 2/3 of the nose. Clinically, rhinophyma is characterized by the aberrant development of the vascularization of the skin of the nose. The nose becomes particularly sensitive, and even a minimal external trauma can cause bleeding. Different treatment methods have been described during the last few years, but surgery still remains the gold standard. The aim is to obtain a reduction of the abnormal tissue, by debulking and fine contouring followed by hemostasis and a very careful postoperative care. Herein we report one case of Rhinophyma treated with the Microdebrider (Storz®). CASE REPORT: A 70 year old male with a diagnosis of rhinophyma was admitted to the Department of Maxillo-Facial Surgery of "Federico II" University of Naples. The patient underwent a debridment of rhinophyma, combining dermabrasion and decortication, using a Microdebrider (Storz®). After the surgery, the wound was covered with an advanced dressing, a collagen sponge equina (Condress®) applied at the end of the procedure and routinely during the follow up control to promote the healing process. CONCLUSION: After 2 months the patient was completely healed without any complications and without any signs of recurrence, obtaining a good aesthetic and functional result. After 25 months of follow up the result is still stable. KEY WORDS: Rhinophyma, Microdebrider.

Autologous fat grafting in facial volumetric restoration.

The authors reported their surgical experience about structural fat grafting in the management of facial volumetric deficit. The purpose of this study was to assess the real indications, cosmetic results, complications, and global patient satisfaction of the Coleman technique in redefining facial contours in congenital and postoperative deformities. A retrospective analysis of 32 patients grafted according to Coleman's technique was performed, and the long-term outcomes and patient satisfaction were evaluated. The mean postoperative clinical follow-up was 14 months. The morphological changes were analyzed by comparing the photographic presurgical facial contour and the postoperative correction of soft tissue defects. All consecutive cases reported showed a progressive fat resorption for 3 months after surgery and its stable integration only after this period. Best results were performed in the treatment of genetically determined syndromes, such as the Franceschetti and Romberg syndromes. The authors suggest this surgical technique also for the treatment of unaesthetic cutaneous abscess cavity after incision and drainage. Unsatisfactory outcomes were obtained in the treatment of the posttraumatic facial scar, which needed more surgical procedures.