“A close shave”: use of a disposable razor blade in the management of rhinophyma
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* Jonathan M Fishman
* Sujata Kundu
* Mark Draper

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*   623
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Rhinophyma is a common clinical problem, generally affecting older males. The treatment for rhinophyma is predominantly surgical. Conventional surgical methods utilise a scalpel, skin graft knife, carbon dioxide laser vaporisation,1,2 electrocautery, cryotherapy, or a combination of the above. We present a simple technique for the surgical management of rhinophyma utilising a disposable razor blade, an instrument readily available in every theatre suite. The technique is simple to perform, safe, efficacious3 and cost effective.

It is the authors’ own method and preference to use a cold excision technique, with a combination of scalpel dissection and a conventional disposable razor blade (fig 1). The disposable razor blade is an extremely useful adjunct to conventional techniques in creating a smooth finish and is convenient, readily available, quick and cost effective. The disposable razor blades may be easily disinfected by soaking them first in aqueous betadine.

![Figure 1](http://casereports.bmj.com/https://casereports.bmj.com/content/casereports/2008/bcr.06.2008.0006/F1.medium.gif)

[Figure 1](http://casereports.bmj.com/content/2008/bcr.06.2008.0006/F1)

Figure 1 Intraoperative photograph.

The disposable razor blade is excellent for refining the shape and re-contouring the nose. It is especially useful for areas that are difficult to mould and refine with the use of the scalpel, thereby achieving a better end aesthetic result3 (fig 2). It has the added advantage of conferring better depth judgement, allowing the rhinophymatous tissue to be excised in layers, thereby preventing inadvertent penetration into the underlying cartilage.

![Figure 2](http://casereports.bmj.com/https://casereports.bmj.com/content/casereports/2008/bcr.06.2008.0006/F2.medium.gif)

[Figure 2](http://casereports.bmj.com/content/2008/bcr.06.2008.0006/F2)

Figure 2 Appearance 2 weeks postoperatively.

The use of a scalpel and razor—in experienced hands and being extremely vigilant of the depth of tissue destruction—can be very useful, cost effective, and convenient in the treatment of rhinophyma.

## Footnotes

*   **Competing interests:** none.

*   **Patient consent:** Patient/guardian consent was obtained for publication

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