A bulbous, red nose is a fairly rare symptom of rosacea that inspires rumors of alcoholism and as such can be a significant source of social discomfort. This condition is often a late development of uncontrolled rosacea with pimples or pustules. Treatment for the nose does not address other symptoms of rosacea, which should be treated once the nose has been restored to a more typical shape and size.
There are multiple techniques that use electricity to make removal of tissue easier. The electrical current first destroys tissue before the surgeon removes it. When used to treat a nose or other parts of the face with thickened, rosy skin, surgeons use a high-frequency electric current that causes heat damage to the unwanted skin. This technique is especially useful for reducing skin bulk without causing any significant blood loss.
The surgeon uses an electric loop like a scalpel, drying and scraping off the layers of skin. Thick, bulbous growths can be removed in this manner, shedding minimal blood. It’s also a relatively painless procedure because medication is used to numb the skin. In cases of very large growths, the procedure may take several sessions, allowing a few weeks between sessions to permit healing. The final result is a shapely nose without scar tissue.
Patients with implanted electrical devices like pacemakers, cochlear implants, etc. should thoroughly discuss this procedure in advance with their surgeon. Electrosurgery may cause problems with the normal functions of such devices, which could lead to a potentially dangerous situation.
Carbon dioxide (CO2) laser surgery
This technique is used to treat moderate to severe cases of rhinophyma. It’s similar to electrosurgery in the sense that it removes tissue with limited blood loss.
A local anesthesia is applied to numb the nose while patients wear blinders to protect their eyes throughout the procedure. The laser is then used to remove skin tissue layer by layer. The skin is vaporized and does not need to be scraped away. A surgical assistant vacuums away the vapor as it emerges. Healing takes several weeks. The treatment does not resolve the erythema.
Darker skinned patients should take note that even darker points of pigmentation may result from this surgery. That said, normal pigmentation can almost always be restored through bleaching therapy, or by simply waiting for 3 – 4 months.
CO2 lasers are excellent tools that provide pleasing results over time. Patients must realize that they will not immediately emerge from surgery and be delighted with what they see in the mirror. Depending on the procedure, the results may appear non-existent — or worse. The dark pigmentation can be especially alarming, while the strange and ugly nose shape after carbon dioxide laser surgery is also disquieting.
Four weeks on, however, the results can suddenly seem miraculous, and after six weeks patients are generally delighted with the outcome. For this reason, it is advisable to not schedule your surgery just before an event where you want to look your best. Wait for at least a month and a half.