Bipolar or monopolar electrosurgery in blepharoplasty: A comparison of surgical outcomes and patient satisfaction

J Cosmet Dermatol. 2020 Dec;19(12):3331-3337. doi: 10.1111/jocd.13478. Epub 2020 Jul 21.

Abstract

Background: An electrosurgery unit (ESU) is the mainstay of bleeding control in blepharoplasty. There are two different types of ESUs: monopolar (m-ESU) and bipolar (b-ESU).

Aims: We used m- and b-ESUs in upper, lower, and combined blepharoplasty and compared their outcomes.

Patients/methods: In this retrospective file review of 292 blepharoplasty patients, we excluded 14 who were lost to follow-up or had missing data; among the 278 enrolled patients, we recorded operative time, a surgeon panel's score for edema and ecchymosis on the third postoperative day, patients' scores of their satisfaction and inconvenience, and postoperative complications.

Results: One hundred thirty-nine patients were included in the m-ESU and b-ESU group. Overall, 105 patients underwent upper blepharoplasty, 77 underwent lower blepharoplasty, and 96 underwent combined blepharoplasty. The total mean operative time in the m-ESU and b-ESU was 67.94 and 62.82 minutes, respectively. This difference was not significant (P > .05). The panel's edema and patient satisfaction and inconvenience scores were significantly better in the b-ESU group (P < .05). There were no significant differences in the panel's ecchymosis score and frequency as well as nature of complications between the m-ESU and b-ESU group (P > .05).

Conclusions: In this cohort of blepharoplasty patients, minimally invasive b-ESUs were efficient in obtaining reliable surgical results with higher satisfaction and lower inconvenience rates of patients than m-ESUs. We would like to recommend the use of b-ESUs in blepharoplasty, especially for plastic surgeons inexperienced in periorbital esthetic surgery.

Keywords: blepharoplasty; electrosurgery; minimally invasive surgical procedures.

MeSH terms

  • Bipolar Disorder*
  • Blepharoplasty* / adverse effects
  • Electrosurgery / adverse effects
  • Humans
  • Patient Satisfaction
  • Retrospective Studies
  • Treatment Outcome