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Use of the Harmonic Blade in Face Lifting: A Report Based on 420 Operations

Firmin, Francoise O. M.D.; Marchac, Alexandre C. M.D.; Lotz, Nicholas C. M.D.

Plastic and Reconstructive Surgery: July 2009 - Volume 124 - Issue 1 - p 245-255
doi: 10.1097/PRS.0b013e3181ab130f
Cosmetic: Original Articles

Background: An important concern for patients who undergo a face lift is the recovery time. Use of the Harmonic blade (Ethicon Endo-Surgery, Cincinnati, Ohio) for surgical dissection and hemostasis in face lift has improved recovery time and greatly reduced the risk of hematomas in the senior author’s practice.

Methods: A retrospective study evaluated the complication rate using the Harmonic blade in face and neck lifting (n = 420) between 2001 and 2007. A prospective study was conducted on 100 cases (October of 2006 to May of 2008) to evaluate the mean operative time, drainage, and recovery time. Results at day 8 were evaluated using on a scale of 1 to 4 (1 = nil tracking to 4 = marked tracking).

Results: The complication rate in 420 cases was low and decreased with experience. Complications included hematoma (n = 5), temporary facial paresis (n = 4), submental lipolysis (n = 3), skin perforation (n = 1), minor skin burn (n = 1), skin necrosis (n = 0), and hair loss (n = 0). Mean operative time for face lift with a superficial musculoaponeurotic system procedure and anterior platysmaplasty was 180 minutes (range, 140 to 210 minutes). Drainage at day 1 was 20 cc (range, 0 to 30 cc). Average return to normal social life was by day 8 (range, 5 to 20 days). Results at day 8 were graded 1 for edema and ecchymosis.

Conclusions: The beneficial effects of the Harmonic blade are obvious objectively and subjectively to both the surgeon and the patients. Understanding the key technical details involved with its use will improve the learning curve for the surgeon as this technology becomes an asset in face lifting.


Paris, France; and Sydney, Australia

From the Department of Plastic Surgery, Clinique Georges Bizet, and the Department of Plastic Surgery, Royal North Shore Hospital.

Received for publication August 22, 2008; accepted January 8, 2009.

Presented at the 42nd Annual Baker Gordon Symposium on Cosmetic Surgery, in Miami, Florida, February 7 through 9, 2008.

Disclosure: None of the authors has any commercial associations that might pose or create a conflict of interest with information presented in this article.

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Francoise O. Firmin, M.D., Department of Plastic Surgery, 23 rue Georges Bizet, Paris 75116, France,

©2009American Society of Plastic Surgeons