Histopathological comparison of incision methods in transconjunctival blepharoplasty: a rat model study

Objective: The choice of incision method is critical in transconjunctival blepharoplasty, affecting both the wound healing process and aesthetic outcomes. This study aimed to compare the histopathological effects of four different incision methods: scalpel, electrocautery, radiocautery, and laser, on wound healing in an animal model. Methods: A total of 54 female Sprague-Dawley rats were divided into nine groups, each subjected to different incision methods on their palpebral conjunctiva. Specimens were collected immediately after the incision and at 1- and 2-week intervals to evaluate wound width, depth, vascular proliferation, inflammation, and fibrosis. Results: Analysis revealed that scalpel and laser incisions resulted in narrower and shallower defects immediately post-operation, while electrocautery and radiocautery produced the most pronounced tissue trauma. By the first week, electrocautery showed the least vascular proliferation, inflammation, and fibrosis, while radiocautery exhibited the most pronounced effects. At the second week, scalpel incisions showed the least inflammation and vascular proliferation, while fibrosis was least observed in radiocautery incisions. Interestingly, despite the initial trauma caused by electrocautery, this method showed less fibrosis over time, suggesting reduced long-term scarring compared to radiocautery. Laser incisions also showed favorable healing outcomes, but with more moderate results compared to the scalpel group. Overall, the study highlights the varying impacts of each incision method on the healing process, indicating that scalpel and laser offer advantages in the early stages of healing, while electrocautery, despite initial trauma, may result in less long-term scarring. Conclusion: The results highlight the importance of selecting the appropriate incision method to minimize complications and optimize healing in transconjunctival blepharoplasty.