Volumeplasty of bulky nose using heat dermabrasion as a minor therapy

Abstract

Background: Ultrathick nasal skin and nodulation is one of the most daunting challenges in cosmetic nasal surgery. Rhinoplasty is a common surgical procedure to correct mostly gross abnormal nasal anatomical variation; however, many patients have minor bizarre shape or deformities that could not be well corrected by ordinary surgical procedures. So we should find other techniques to correct these unwanted or undesired nose shape abnormalities. Objective: The purpose of this article is to perform heat dermabrasion to reduce the size of bulky nose and to create new alar groove and to remove nose nodulations, acne or traumatic scarring. Patients and methods: In this study, we collected 40 patients with bulky nose during the period from 2009 through 2019; 21 females and 19 males and their ages ranged from 20-65 years. An Informed consent was taken from each patient before starting the study, after full explanation about the procedure. All patients had bulky nose, some had nodulation of nose and acne or traumatic scarring. Only one patient had history rhinophyma of several years duration. All patients were treated with heat dermabrasion using diathermy needle after local xylocaine anesthesia and patients were received topical antiseptic and oral antibiotics to be seen after 2 weeks. Then topical corticosteroid was used to prevent post-inflammatory pigmentation. Results:A total of 40 patients diagnosed with bulky nose were enrolled in this study; 21 (52.5%) patients were females and 19 (47.5%) were males. Age of patients ranged from 20-65 years with a mean of 42.5 years. The duration of the condition ranged from few months to several years. In all patients with bulky nose were improved and alar groove were created or maximized and gave satisfactory cosmetic results using heat dermabrasion. Post-inflammatory hyperpigmentation was noticed but overtime was gone. Conclusion: heat dermabrasion using diathermy is new simple innovative minor technique to reduce size of bulky nose or small cosmetic abnormalities that could not be corrected by the standard classical rhinoplasty.This were carried under local anesthesia, need one session with minimal down time, without complications. Compared to dermabrasion by diathermy, CO2 dermabrasion is costy and usually needs many sessions, in addition to the undue laser exposure.