Background Hematoma is the most common complication in facelift surgery. It has a reported incidence ranging from 0.2 to 8%. Tranexamic acid (TXA) is an antifibrinolytic agent capable of minimizing blood loss, and its use in plastic surgery is quite new. The literature review indicates that there are no formal guidelines for dosing and standardization of TXA use. We sought to evaluate the efficacy of intraoperative local irrigation of TXA in reducing the incidence of hematomas in patients undergoing facelift surgery. Methods A prospective cohort observational comparative study was conducted between November 2018 and November 2019 with 30 patients undergoing primary facelift surgery at the Ivo Pitanguy Institute in Rio de Janeiro, Brazil. The participants were divided into two groups: group I, patients who underwent facelift with 2.5% topical TXA irrigation as a new routine of the service, and group II, patients who underwent facelift without topical TXA irrigation as a routine. Results Drainage output in the first 24 h, hematoma formation, and complication rate were evaluated. It was found that local intraoperative TXA irrigation reduces drainage output in the first 24 h by 71% compared with group II (median 10 ml (8-22 ml) versus 35 ml (19-50 ml); p = 0•009). The rate of postoperative complications (p = 0.1) and hematoma (p = 0.08) was lower in the group with intraoperative local irrigation with TXA. This was not statistically significant. Conclusion Local TXA irrigation seems to decrease bleeding and has been shown to be effective in reducing drainage output in the first 24 h postoperatively.Level of evidence: Level III, risk / prognostic study.

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The poor results of previous procedures were disappointing to many patients and discouraged many others from undergoing thigh dermolipectomy. Using the Pitanguy flap demarcator for markings and the medioanterior scar extension, satisfactory results were increasingly common, and a growing number of patients may be encouraged to undergo thigh dermolipectomy procedures.

Chemical peeling for skin originated in ancient culture: Egypt, Mesopotamia and Africa. Medical knowledge relating to chemical peels is the result of centuries of experience and research. Many substances used in peeling have been described, with a more or less marked action. Objective. In this work we aim to describe the concept of biocomplementation through the use of a needle-free system called 3Phasic System ® . Methods. The 3Phasic System ® consists of a peeling (containing various exfoliating substances) associated with a topical home protocol consisting of topicals and probiotics. This protocol also favors the correction of incorrect eating habits also thanks to the integration with vitamins and probiotics. In this protocol a superficial peeling is used and the indications are: skin resurfacing of the face or body even in dark phototypes, acne vulgaris results, postinflammatory hyperpigmentation, melasma, scars and photodamage. The 3Phasic System ® consists of many agents in reduced concentrations, promoting the efficacy of individual agents and reducing adverse effects. However, familiarity with the properties of peels is very important to avoid negative effects. The possibility of administering 3Phasic System ® on a monthly basis together with the correction of incorrect eating habits, the integration of deficient factors, the administration of probiotics and the application of correct home cosmetics has proven to be effective and safe in patients. The evaluation of the efficacy of the 3Phasic System ® was evaluated through ANTERA 3D ® and VISIA ® in 450 patients in 18 th months. Results. No adverse effects were found in any of the patients. All patients reported positive feedback to the physician in the follow-up session. Evaluation with Antera 3D and Visian highlighted the efficacy of the treatment expressed in percentile points (from +20 to +80). There is no difference in the effectiveness of the 3Phasic System ® between men and women as the results are comparable. Conclusions. The concept introduced with the 3Phasic System ® is one of biostimulation and biocomplementation and not of rejuvenation as the duration of the treatment begins with the first application and continues with topical and oral home treatments, inserting the patient in an aesthetic journey that goes beyond the individual medical treatment.