Excision or surgical planing of skin of nose for rhinophyma
CPT4 code
Name of the Procedure:
Excision or Surgical Planing of Skin of Nose for Rhinophyma
Summary
This surgical procedure involves the removal or reshaping of the thickened, bulbous skin on the nose, commonly known as rhinophyma. The process helps to restore a more normal appearance and function to the nose.
Purpose
The procedure addresses rhinophyma, a skin disorder resulting in an enlarged, bumpy, and red nose due to thickened skin and excess tissue growth. The goals are to improve nasal aesthetics and alleviate any associated functional issues, such as breathing difficulties.
Indications
- Noticeable thickening and redness of the nasal skin
- Bulbous appearance of the nose
- Presence of nodules or excess tissue causing cosmetic or functional concerns
- Impaired nasal function or breathing
- Psychological distress or self-esteem issues related to nasal appearance
Preparation
- Patients may need to fast for a certain number of hours before the procedure.
- Medication adjustments, especially blood thinners, may be necessary.
- Pre-procedure tests such as blood work or imaging studies may be required.
- Patients should follow specific skin care instructions and avoid certain skin products.
Procedure Description
- The patient is positioned comfortably, usually in a seated or reclined position.
- Local anesthesia or sedation is administered to ensure comfort.
- The surgeon uses scalpels, lasers, or dermal planing tools to remove or reshape the thickened skin.
- Excess tissue is carefully excised to achieve a smoother and more natural appearance.
- The treated areas are dressed, and appropriate wound care measures are explained.
Duration
The procedure typically takes between 1 to 2 hours, depending on the extent of rhinophyma.
Setting
This procedure is usually performed in an outpatient setting, such as a hospital or surgical center.
Personnel
- Surgeons specialized in dermatology or plastic surgery
- Nurses to assist with the procedure and postoperative care
- Anesthesiologist or nurse anesthetist, if sedation is used
Risks and Complications
- Infection
- Scarring
- Bleeding
- Changes in skin sensation
- Asymmetry
- Need for further surgery if not adequately addressed in a single procedure
Benefits
- Improved nasal appearance
- Enhanced self-esteem and psychological well-being
- Better nasal function, if it was impaired
- Results are typically noticeable immediately, with further refinement over weeks to months.
Recovery
- Patients will receive detailed wound care instructions.
- Expect mild discomfort and swelling for a few days.
- Antibiotics and pain relievers may be prescribed.
- Avoid strenuous activity for several weeks.
- Follow-up visits are necessary to monitor healing and suture removal, if applicable.
- Full recovery and final results can take several months.
Alternatives
- Medical treatments with topical or oral medications, though less effective
- Laser therapy to reduce some of the excess tissue
- Consideration of the lack of immediate results and potential need for repeated treatments with non-surgical options
Patient Experience
During the procedure, the patient might feel minimal discomfort due to anesthesia. Post-procedure, patients may experience swelling, tenderness, and minor pain, which is managed with prescribed medications. Most patients can return to daily activities within a few days but should follow the care plan for optimal recovery.