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Recurrent Rhinophyma: A Case of Triple Relapse and Therapeutic Challenges.

Bilal Aslam¹, Muhammad Abbas², Syed Muhammad Tayyab¹

¹University of Lahore Lahore Pakistan.

Clinical Case Reports

|May 14, 2026

Summary

Recurrent rhinophyma requires careful surgical management. A modified deep tangential excision preserving adnexal structures offers a durable solution for severe cases, preventing future recurrence.

Keywords:

case report nasal reconstruction phymatous rosacea recurrence rhinophyma surgical excision tangential excision

Related Experiment Videos

Area of Science:

Dermatology
Plastic Surgery
Surgical Pathology

Background:

Rhinophyma recurrence after surgery is a challenge.
Incomplete removal of deep pilosebaceous units contributes to recurrence.
Previous cold-steel excisions failed in this patient.

Purpose of the Study:

To present a successful surgical strategy for severe, recurrent rhinophyma.
To highlight the importance of preserving deep adnexal structures.
To demonstrate a durable outcome in a challenging case.

Main Methods:

Modified deep tangential excision to the deep dermal plane, preserving nasal perichondrium.
Selective, tension-free suture re-approximation for contour.
Secondary intention wound healing.
Cold-steel excision for artifact-free histopathology.

Main Results:

Complete removal of rhinophymatous tissue.
Preservation of essential adnexal remnants for re-epithelialization.
Histopathology confirmed sebaceous gland hypertrophy and excluded malignancy.
No recurrence at 18-month follow-up with stable nasal contour.

Conclusions:

A surgical approach balancing thorough debulking with adnexal preservation is crucial for recurrent rhinophyma.
This modified technique provides a durable, long-term outcome.
Effective management of severe rhinophyma requires meticulous surgical planning and execution.