Role of the argon beam coagulator in facial rejuvenation surgery.

[OBJECTIVE] To compare the hemostatic effectiveness of a new electrosurgical unit, the argon beam coagulator, with current methods of electrocoagulation.

[DESIGN] A nonrandomized control trial of 20 patients undergoing rhytidectomy.

[SETTING] Two academic tertiary referral medical centers.

[PARTICIPANTS] Twenty male patients having moderate to major degrees of facial ptosis.

[INTERVENTION] All 20 patients underwent a standard rhytidectomy with hemostasis provided by the argon beam coagulator on the right side and conventional electrocoagulation on the left side.

[OUTCOME MEASURES] Improved hemostasis with minimal depth of injury, length of procedure, decreased blood loss, edema, and ecchymosis, and the ability to coagulate indiscriminately around and over neural tissue without damage (all listed in the literature as advantages of the argon beam coagulator).

[RESULTS] Poor hemostatic ability was observed with concomitant increased incidence of blood loss, edema and ecchymosis, major hematoma, and length of surgery. Also noted were increased rates of flap compromise and the potential for damage to vital neural structures.

[CONCLUSION] Our results do not agree with the list of advantages attributed to the argon beam coagulator in the literature.