More evidence that radiofrequency may not deliver improved recovery or less scaring

The authors of this prospective randomized double-blind study compared clinically and histologically the effects of radiofrequency versus scalpel incision for upper blepharoplasty. They concluded that although there was more zone and depth of tissue damage in the radiofrequency group, sensation recovery and scar scores were the same in both groups. This adds to the body of literature failing to demonstrate improved recovery or less scarring with laser or radiofrequency versus scalpel incisions.

Twenty-three upper eyelid dermatochalasis patients underwent bilateral upper blepharoplasty performed by the same surgeon. One eye of each patient was randomly assigned to radiofrequency incision and the other to the use of a scalpel. Patients with skin disease or any disease resulting in peripheral neuropathy or who had undergone previous eyelid surgery or trauma were excluded.

A 4.00 MHz high frequency low temperature radiosurgical unit (Surgitron Dual Frequency RF/120 IEC, Ellman International) was used on one eyelid and a scalpel and scissors on the other. The surgery involved a supratarsal eyelid crease incision and skin and subcutaneous tissue excision. Incisions were closed with separated 6-0 nylon sutures, which were removed after six days. Patients were followed for six to seven months after surgery.

Mean aesthesiometry readings, which measure eyelid sensations, significantly decreased in both treatment groups compared with preoperative measurements. However, mean sensation recovery was nonsignificantly better in the radiofrequency-treated eyes compared with those treated with conventional surgery.

Manchester scar scale scores indicated nonsignificantly less scarring in eyes treated with radiofrequency versus traditional surgery. Histopathologic examination found that zone and depth of tissue damage were higher in radiofrequency-treated eyes, which the authors said was due to the application of heat to the skin with radiofrequency treatment.

Financial Disclosures
Dr. Goldberg has no financial interests to disclose.