Clinicopathologic Comparison of Radiofrequency Versus Scalpel Incision for Upper Blepharoplasty

Abstract

To compare the sensation recovery, scar formation, and histopathologic aspects of upper blepharoplasty eyelid incision performed with radiofrequency or scalpel. In a prospective, randomized, blind, comparative, interventional study, 46 eyelids from 23 subjects underwent upper blepharoplasty using radiofrequency incision on one side and a scalpel on the other side. Exclusion criteria were diseases resulting in peripheral neuropathy such as diabetes mellitus, previous upper eyelid surgery or trauma, and history of skin disease. Eyelid sensation was measured preoperatively and 1 week, 1 month, and 6 to 7 months after surgery by a masked observer. Eyelid scar was evaluated by 2 masked observers at final follow-up. Histologic examination for zone and depth of tissue damage, hemorrhage, and inflammatory cell reaction was performed in a masked fashion on 16 eyelids. The mean patient age was 52 years (SD, 5.48 years). Mean aesthesiometry reading significantly decreased in both groups at all follow-up visits in comparison with preoperative measurement (p = 0.000). Mean sensation recovery was insignificantly (0.2 < p < 0.6) higher in the radiosurgery group at all follow-up visits. Mean scar score was insignificantly (p = 0.055 for observer 1, and 0.241 for observer 2) less in the radiosurgery group. The scar score was not significantly different between Fitzpatrick skin types 3 and 4, scored by either observer. The zone and depth of tissue damage on histopathologic examination was greater in the radiofrequency group. However, the hemorrhage and infiltration of inflammatory cells were the same. There was no significant difference between radiofrequency and scalpel incision in upper blepharoplasty with regard to sensation recovery and scar formation. Histologic zone and depth of tissue damage were greater in the radiofrequency group.