Bulbous Nose and Nose Job

[melanie]

Hi, I have rosacea and was diagnosed with this about 2 years ago. In this time my nose has become quite bulbous. I have just been looking at some holiday pics and suddenly realize just how much my nose has changed. It is very noticeable. Is it possible to fix it by getting a nose job? Would my bulbous nose grow back even after the procedure? Any advice would be appreciated. Thank you!

[David Pascoe]

Hi Melanie,

Have you been able to get an opinion from a derm ?

I think it very much depends on what treatment you have as to how permanent it is. There are lots of options from Photodynamic Therapy, accutane, CO2 laser, surgical correction etc. Your doc should be able to say what sort of permanence you can expect. I would expect surgical correction would give a long term benefit but is likely also to have the most potential for scarring. At the other end, accutane might be a less invasive possibility.

Perhaps others can report on what has worked for them. Otherwise, hopefully a dr. can give you a more definite answer.

davidp.

[xjoyce]

Hi

I noticed your posting on swollen nose and I was wondering how you are getting on.

I have severe nose burning and a swollen nose which is now distorting. I have no redness nor flushing but I do have severe burning. I was quite shocked when you stated that you were considering plastic surgery. I went to two different plastic surgeons and both have stated that there is no surgeon that would operate on the nose where there is inflammation.

My nose swelling started on just the one side, then it went to the other side and now it has gone to the tip. It burns severely and I noticed my cheeks are swollen. My face is chalk white.

Kind regards
Joyce

[PatrickHoustonTX]

Hello,

I am a long time rosacea victim. I also have the bulbous nose that has gotten quite worse since I was in my twenties. I have a consult with a plastic surgeon this week to discuss my options. I will keepo you posted.

Pat

[Lisamouries]

Welcome Pat.
Hope your appointment goes well. Fingers crossed.

[Lisamouries]

Hi Joyce.
Have you taken antibiotics to treat the inflammation?

Some info on Rhinophyma:
http://www.nlm.nih.gov/medlineplus/ency ... 001037.htm

[David Pascoe]

Just wanted to make sure that Pat and Joyce have seen the papers I have collected on treating rhinophyma with accutane.

Isotretinoin has also been demonstrated to decrease nasal volume in rhinophyma [70][75]. The most significant regression has been noted in younger patients with less advanced disease [75].

Biopsy specimens from phymatous skin prior to isotretinoin therapy showed numerous large sebaceous glands. During isotretinoin therapy, the glands diminished in size and number. Other studies have confirmed the usefulness of isotretinoin for phymatous change [76][77].

and

Phymatous subtype

Isotretinoin monotherapy is beneficial for early to moderate phymatous rosacea. Advanced phyma should be treated with surgical therapy or the combination of surgery followed by isotretinoin therapy. Surgical approaches to the reshaping of rhinophyma have included the use of a heated scalpel, electrocautery, dermabrasion, laserablation, tangential excision combined with scissor sculpturing, and radio frequency electrosurgery. Often a combination of these approaches is used to obtain the best aesthetic result [76][117][118].

It might also be worth having a read of low dose accutane for more information about accutane and rosacea.

davidp.

[Sputnix]

My nose has probably been bad for a number of years, but seeing me in a series of photographs and the reactions of people when they saw my nose (during a vacation in Paris where I think EVERYONE had perfect skin) prompted me to the dermatologist to seriously address mine. They have put me on doxycycline and metrogel to see if that would help. It seems the doxycycline did help reduce some flareups, but they seem to be returning. The metrogel was to help with the inflammation and it might have helped somewhat. The challenge I see when I read the various articles on plastic surgery is that it doesn't sound like a sure solution. I want to stay connected into this panel because it might at least be encouraging to hear other experiences.

[Lisamouries]

Sputnix. Are you still taking doxycycline? Sometimes stopping too abruptly can cause flare-ups. Also you need to carry on with the metrogel for between 6 to 8 weeks before seeing any real improvement. As for plastic surgery you really need to get the condition under control before any attempts. Are you seeing your derm again to assess?

[Sputnix]

I have been on doxycycline and metrogel since December 10 -- and have been taking the tablets and applying the gel regularly.