PMC6536489_01
Preoperative anterior (A) and lateral views with marked area of excision (B).
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We present the case of a 77-year-old man with a large tuberous "Cyrano's like" nose, severe nasal deformity and mild nasal airway obstruction (Fig. 1).
Intraoperative pictures showing the full-thickness excision until the nasal perichondrium (A) and ADM application on the defect area (B).
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He underwent total surgical excision of the hypertrophied tissue until the nasal perichondrium, and an ADM (Integra  Dermal Regeneration Template, 5 x 5 cm) was placed on the defect area (Fig. 2).
12-months postoperative follow-up.
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Nevertheless, the patient was not satisfied by the aesthetic outcome; therefore he requested further surgical revision due to the different thickness of the reconstructed tissue compared to the surrounding skin with a "step-like effect" (Fig. 3).