The Johnson and Johnson Company developed the Harmonic Scalpel in 2000. In 2005 French cosmetic surgeon Francoise Firmin wrote down his first experiences of using it during facial surgery. Since then cosmetic surgeons around the globe have been using the new instrument, in the New World Randy Robinson was the first to use the Harmonic Scalpel.
What is the difference between this new instrument and the ones used before it? What are its advantages? The Harmonic Scalpel is a hand-held tool with a 2 cm long and 2 mm thick, curved double blade.
During its development it was meant to be used in procedures (unlike abdominal surgery) where only a small incision is available for the surgeon to perform tissue dissection. Thus, the possibility arose for Firmin to use it during facial surgery.
While raising the skin and tissue in front of the ear we are only able to see through a small incision. It is less the raising of the tissue that is difficult and more the coagulation of the occurring bleeding while we advance toward the midline of the face under the skin. This bleeding (due to the size of the incision) cannot be seen, and therefore is more difficult to coagulate. There is no need for this while using the Harmonic Scalpel, as the new instrument coagulates and cuts simultaneously. While using it we are able to cut smoothly and evenly without bleeding, we can safely progress farther from the location of the incision.
Facial surgery, the procedure itself remains the same, but with this new method it is now safer and better results can be achieved. Because there is less tissue damage (less heat, smaller necrotic zone) there is a slighter chance of post-operative bleeding, thus the postoperative stage is faster and complication-free.
The method became known as Firmin Facial Surgery.
Based on the previous, Robinson named the breast surgery he performed with the instrument ‘Harmonic Breast Augmentation’. Only a small incision is available for sight and coagulation during this procedure as well, therefore this new instrument is a big advantage. The advantages mentioned during facial surgery are present in this case as well, minimal bleeding, more precise tissue dissection, less pain and faster post-operative recovery time.
Firmin Facial Surgery
Ultrasonic coagulation has been used in the field of general surgery for years, but has only been used in cosmetic surgery for the past few years. Its advantage is based on a smaller heat effect, which means less tissue damage leading to a faster surgery and a faster recovery time.
The ultrasound not only coagulates, but also incises simultaneously, thus saving even more time during the procedure.