Tranexamic Acid Application in Facial Aesthetic Surgery: An Umbrella Review

Abstract

Background Tranexamic acid (TXA) is an antifibrinolytic agent that is considered as one of the latest interventions currently being investigated in the field of facial aesthetic surgeries. As its predicted to be effective in reducing intraoperative and postoperative complications of facial aesthetic surgeries. Objectives This review focuses on giving readers a comprehensive overview regarding the use of TXA in facial aesthetic surgeries. Methods In this umbrella review, data was extracted from existing systematic reviews and meta-analysis that focused on the use of TXA in facial aesthetic surgeries. We searched PubMed, Embase and Scopus databases. Data was extracted using a standard format and the AMSTAR-2 tool was used to assess the quality of the included reviews. Results In total, our study included 14 systematic reviews and meta-analysis all of which evaluated the effect of TXA on facial aesthetic surgeries. Which included rhinoplasty, septorhinoplasty, rhytidectomy and blepharoplasty. The majority of the included studies focused on reporting the effect of TXA on blood loss volume (BLV) and duration of surgery (DOS) as well as other postoperative complications. 11 out of the 12 studies that focused on rhinoplasty showed that TXA used reduced BLV. In addition, in 8 studies that were focusing on DOS, majority showed reduction in DOS with TXA use. While in case of septorhinoplasty 3 studies revealed that TXA use decreased BLV. Moreover, in case of rhytidectomy3 out of 6 SR showed reduction in BLV while 2 reported reductions in DOS. Conclusions We conclude that the use of TXA is indeed efficient in reducing BLV and DOS, in addition to some of the complications that can occur during or after facial aesthetic surgeries. However, in order to reach a final decision on the implication of the use of TXA in facial aesthetic surgeries, further studies should be established using a standardized protocol in assessing the desired outcomes.