Bipolar scissors in facial plastic surgery

Many methods are available to the facial plastic surgeon for elevating and separating tissue, from cold steel to monopolar cautery to various laser-cutting technologies. Bipolar cautery has replaced monopolar cautery as the optimal hemostatic technique because of its decreased tissue damage and improved capabilities. Bipolar scissors concurrently offer a dissecting technique with hemostatic capability. Little exists in the otolaryngology literature on the use of bipolar scissors for soft tissue dissection.

To describe our experience using bipolar scissors in a variety of facial plastic and reconstructive procedures.

Tertiary care referral academic center.

We retrospectively reviewed 78 procedures performed using bipolar scissors between June 1997 and August 1999. In facial plastic cosmetic surgery, bipolar scissors were used 31 times for deep plane face-lifts and 16 times for endoscopic browlifts. In facial plastic reconstructive surgery, bipolar scissors were used in 15 radial forearm free flaps, 10 fibula osteocutaneous flaps, 3 rectus abdominis free flaps, and 3 latissimus dorsi myocutaneous free flaps.

In all procedures, bipolar scissors facilitated the dissection. By allowing for a drier field, less time was required to elevate the flap and obtain hemostasis. Complications were not increased compared with historical controls. In the harvesting of fibula osteocutaneous free flaps, use of bipolar scissors allowed harvesting without use of a tourniquet.

Bipolar scissors, a new technology in facial plastic surgery, allow the same control as sharp dissection and provide simultaneous hemostasis.