This is a kind gentleman who has a skin condition on his nose that is termed a rhinophyma (rhino-phy-ma). A rhinophyma is the end result of an untreated skin condition called Rosacea. There are some famous people who were inflicted with this condition, such as Karl Malden, W.C. Fields, and to a lesser extent ex-President Bill Clinton.
He sought treatment because as a janitor at an elementary school he was often teased for his nasal appearance. The condition is easy to remedy but involves excision of the thickened nasal skin, typically with a CO2 laser or other specialized instruments. I used a CO2 laser in this case. The procedure can be performed with local anesthesia and mild sedation or under a general anesthesia as was done in this case. The majority of the healing occurs within 7 to 10 days, with the result significantly enhancing the patient’s nasal appearance, as in the case presented here.