Sandra Lee has her work cut out for her in the new season of Dr. Pimple Popper.

In PEOPLE’s exclusive clip from the TLC hit series’ season 4 premiere, Lee, 49, meets a new patient, David, who is suffering from Rhinophyma, which has caused a buildup of tissue on his nose.

“You are a good looking guy under there. We just got to take that nose off. That extra nose,” she says to David, before explaining the circumstances behind his condition.