Rhinophyma

Rhinophyma is a disfiguring condition of the nose associated with the overgrowth of skin and sebaceous glands. It is considered to be the most severe expression of acne rosacea and it is most commonly limited to the lower part of the nose; nevertheless, it can occasionally also involve the chin and forehead.

The condition is more common in Caucasian men in their fifith to seventh decade of life and has been traditionally linked with excessive alcohol use in the past; this association has not been explicitly confirmed in the scientific literature. Most patients present for medical attention based on gradual changes in the size of their nose with most noticing the tip and nostrils becoming bulkier with time.

Sometimes the diagnosis is made by a dermatologist or general practitioner as part of acne rosacea, which can present in a variety of ways including facial flushing, visible blood vessels, persistent redness and pimples on the cheeks/nose. Having rhinophyma can lead to disharmony in facial features and this may cause some people to feel particularly conscious and face issues with low self-esteem.

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About this condition

In general, non surgical therapy includes the use of isotretinoin tablets ahead of any surgical/laser intervention. This medication helps decrease the production of sebum, shrink the size of sebaceous glands and hence optimises the target areas before treatment. There are a number of laser and surgical procedures able to give long-lasting results.

Treatment options include:

Scalpel reduction: this traditional technique aims to remove bulky tissue and sculpt the nose into a more natural shape. It has now been superseded by other modalities.

Electrosurgery: direct removal of excess tissues using a loop shaped handpiece powered by electricity.

Dermabrasion: this technique is mainly used as an adjunct to other modalities to further sculpt the profile of the nose.

Carbon dioxide laser ablation: Over the last decade, this has become the gold standard for rhinophyma treatment; it provides the best aesthetic results with the lowest side effect profile compared to other treatment options.

These are all procedures that will involve either sedation, or most commonly a local anaesthetic. The duration of recovery will very much depend on the extent of the procedure and modality of treatment chosen. Following carbon dioxide treatment, it typically takes a couple of weeks for recovery and three to six months for the final results to be fully appreciated.

The optimal procedure for you will depend on the extent of rhinophyma, the overal skin tone and whether there are medical conditions complicating your management plan.

A skilled plastic surgeon will be able to perform a thorough assessment, consider your aesthetic objectives and recommend the best action plan for you.

Mr Ioannis Goutos is a London-based plastic surgeon with a particular interest in scars and laser surgery treatments. He provides thorough assessments and gold standard post-treatment care and follow up.

Testimonials

Mr Goutos is delighted to share some of his patient and peer feedback on their experiences of his services.

Louise Steel

2023-08-16

Mr Goutos performed keloidectomy surgery on both my earlobes, and I am so grateful to have been referred to him. From the first consultation, through surgery, and now my 3-month follow-up, I have nothing but good words to say.

Luke Ward

2023-07-10

This man is an extremely intelligent, professional gentleman. He will set realistic expectations from the beginning and will not ‘beat around the bush’ so-to speak. From the initial consultation to post-surgery, it has been a rollercoaster ride. However the high level of expertise & professionalism Mr Goutos maintained has been impeccable. All I can say to any other individual considering treatment with Mr Goutos, is that you are in incredibly safe hands. And on top of this, he has a great sense of humour. I wish nothing but the best for this man, and the best results for his future patients.

Mauricio Lucas

2023-07-06

Outstanding Doctor - Exceptional Expertise I recently had the pleasure of consulting and also going through surgery. Dr. Goutos removed a large class of keloids from my back and chest, and without a doubt, I can confidently say that he is the best doctor I have ever had the privilege of seeing. From the moment I entered his practice, I was immediately struck by his professionalism, knowledge, and exceptional bedside manner. Dr. Goutos possesses an extraordinary level of expertise in his field, and his technical skills are truly remarkable. His ability to diagnose and treat medical conditions is unparalleled, and I have personally witnessed his remarkable success in improving the health and well-being of countless patients. What sets Dr. Goutos apart is his genuine care and concern for his patients. He takes the time to listen attentively, ensuring that he understands every aspect of the medical issue at hand. He communicates clearly and effectively, explaining complex medical concepts in a way that is easy to comprehend, which greatly helps in alleviating any concerns or fears. One aspect that impressed me greatly was Dr. Goutos' commitment to staying updated with the latest advancements in his field. He incorporates cutting-edge techniques and treatments into his practice, ensuring that his patients receive the highest standard of care available. This dedication to continuous learning and improvement is a testament to his unwavering dedication to his profession. Additionally, the support staff at Dr.Goutos' practice deserves recognition for their exceptional service. They are friendly, compassionate, and highly efficient, ensuring that appointments run smoothly and patients feel comfortable throughout the entire process. Overall, I cannot emphasize enough how fortunate I feel to have found Dr.Goutos' exceptional skills, genuine care, and unwavering commitment to his patients make him a truly outstanding specialist. I wholeheartedly recommend him to anyone seeking top-notch medical care.

Kashmala Khan

2023-01-26

Mr. Goutos and his team did an amazing job reversing a scar I had on my forehead. This was a very old scar and had bothered for many years. The laser treatment and fat transfer procedure has changed my life and given me so much confidence. I would definitely recommend him, he is a fantastic and very skilled surgeon. Thank you so much!

Javier

2023-01-14

Mr Goutos and his team removed some lipomas from my arms. The initial consultation right through to the aftercare was professional, sensitive and genuine. Mr Goutos put me at ease right from the start, discussing my history and background and then discussing the various options for the incisions and sutures. The incisions were quick, efficient and professional. I felt completely at ease knowing I was in expert hands. The incisions were extremely neat and have closed and scared really well. I had a number of questions after the operation and one of the sutures became infected. Mr Goutos was quick to make an appointment for me, see me and deal with the infection and offered for me to see him again if the infection didn’t calm down. He was genuinely empathetic to my needs and took time to check each scare, explain things and assure me along the way. He didn’t at any point, make me feel I was asking silly questions or too many. I highly recommend Mr Goutos for his exceptional incisions and suturing as well as his professional conduct, caring approach and after care. The whole experience was smooth and easy and I am very grateful for what he has done for me.

Ieva Lihovida-Yarlett

2022-12-07

We came to see Dr Goutos a few month ago to remove invasive spider nevus on my 9 year old sons nose . After a lovely consultation with Dr Goutos , he suggested to do several laser treatment sessions. After a few sessions we already noticed a massive improvement. On the final laser treatment session the spider nevus was completely gone. Thank you to the Dr Goutos for tackling the problem so rapidly and with great results!

Amy Munson

2022-10-27

We took our 4yr old daughter to Mr Goutos following an accident which resulted in a small burn scar on her cheek. Mr Goutos gave us various options and we went for laser treatment. After 4 appointments the scar has gone! The care that Mr Goutos gave us was exceptional and so good with children. He made us feel very comfortable and confident in his ability. I would recommend him to anyone if they were looking for a doctor in that particular field. Can't thank him enough.