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Background <p>The method of tissue dissection in reduction mammaplasty may influence intraoperative efficiency, postoperative recovery, and scar quality. While scalpel dissection remains the traditional standard, monopolar electrocautery is increasingly used due to its hemostatic advantages.</p> Methods <p>This retrospective split-breast study included patients undergoing bilateral reduction mammaplasty. One breast was dissected using a scalpel and the contralateral breast using monopolar electrocautery. Intraoperative parameters, postoperative pain, drainage, and scar quality, assessed using the Patient and Observer Scar Assessment Scale (POSAS) were compared within the same patient.</p> Results <p>Forty patients were analyzed. Monopolar electrocautery resulted in significantly reduced intraoperative bleeding and shorter hemostasis time, although excision time was longer. Early postoperative pain and drainage volume were higher on the electrocautery side but equalized during follow-up. Scar quality at 6 months was comparable between techniques.</p> Conclusions <p>Monopolar electrocautery provides effective hemostasis with comparable mid-term cosmetic outcomes to scalpel dissection in reduction mammaplasty. When used with careful technique, it represents a reliable alternative to cold knife dissection.&#xa0;Although electrocautery reduces bleeding and hemostasis time, early postoperative pain may be higher. Mid-term scar quality seems comparable between techniques. </p> Level of evidence <p>Level III, therapeutic study.</p>

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Scalpel versus monopolar electrocautery in reduction mammaplasty: an intra-patient comparative study 

  • 期刊论文

  • 发表日期：

    2026年8月4日

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  • Ceyhun Uzun,
  • Berkay Çınar,
  • Mehmet Bayram,
  • Kübra Nur Baktikar,
  • Emrah Kagan Yasar,
  • Murat Sahin Alagoz

摘要

Background

The method of tissue dissection in reduction mammaplasty may influence intraoperative efficiency, postoperative recovery, and scar quality. While scalpel dissection remains the traditional standard, monopolar electrocautery is increasingly used due to its hemostatic advantages.

Methods

This retrospective split-breast study included patients undergoing bilateral reduction mammaplasty. One breast was dissected using a scalpel and the contralateral breast using monopolar electrocautery. Intraoperative parameters, postoperative pain, drainage, and scar quality, assessed using the Patient and Observer Scar Assessment Scale (POSAS) were compared within the same patient.

Results

Forty patients were analyzed. Monopolar electrocautery resulted in significantly reduced intraoperative bleeding and shorter hemostasis time, although excision time was longer. Early postoperative pain and drainage volume were higher on the electrocautery side but equalized during follow-up. Scar quality at 6 months was comparable between techniques.

Conclusions

Monopolar electrocautery provides effective hemostasis with comparable mid-term cosmetic outcomes to scalpel dissection in reduction mammaplasty. When used with careful technique, it represents a reliable alternative to cold knife dissection. Although electrocautery reduces bleeding and hemostasis time, early postoperative pain may be higher. Mid-term scar quality seems comparable between techniques.

Level of evidence

Level III, therapeutic study.