Use of Tranexamic Acid in Aesthetic Surgery: A Retrospective Comparative Study of Outcomes and Complications

Abstract

Background: Bleeding is a potential complication of aesthetic surgery. Surgeons have adhered to the principle of minimizing blood loss. Tranexamic acid (TXA) is an antifibrinolytic medication capable of reducing bleeding. This study aimed to investigate TXA and its effect on complications and overall outcomes in aesthetic surgery patients. Methods: This retrospective chart review of patients undergoing various aesthetic procedures between 2019 and 2022 was conducted in Riyadh, Saudi Arabia. Preoperative and postoperative hemoglobin levels, blood transfusions, and complications were the primary outcomes. Furthermore, the predictors of giving TXA were studied. Results: In total, 435 patients were included in the study. TXA was administered to 181 patients (41.6%). Significantly higher proportions of patients who received TXA underwent trunk aesthetic surgery (P < 0.001), and those who received TXA underwent combined procedures more frequently than non-users (P < 0.001). The mean operative time and length of hospital stay were significantly longer among patients who did not receive TXA (P < 0.001, and P < 0.001, respectively). Most predictors for using TXA were significantly associated with performing liposuction (OR = 5.5), trunk aesthetic surgery (OR = 4.9), and undergoing combined procedures (OR = 2.7). No significant difference was noted in the rate of complications between the two cohorts. Conclusions: Although our data show improvement in patient outcomes in multiple aspects, the heterogeneity of our cohort makes us unable to draw definite conclusions to recommend the use of TXA in aesthetic surgery. Thus, a randomized controlled trial is necessary to support the findings of this study.

Use of Intravenous Tranexamic Acid in Patients Undergoing Plastic Surgery: Implications and Recommendations per a Systematic Review and Meta-Analysis

“…The eligibility criteria were applied to 1630 research articles, and only 13 research articles met the inclusion criteria. All 1617 research articles were excluded due to screening and selection by PRISMA guidelines [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46].…”

“…Red or minus: High-risk aspects of included studies, Green or plus: Low-risk aspects of included studies, Blank or white: Unclear [34][35][36][37][38][39][40][41][42][43][44][45][46]…”

“…Through 13 included studies, about 1641 patients who underwent aesthetic plastic surgery have been discussed. To produce heterogeneity in results, these studies have been taken from different countries: four studies from Iran [37,38,41,45]; three studies from the USA [40,43,44]; two in Turkey [36,42]; and one in Singapore [34], one in Saudi Arabia [35], one in Israel [39], and one in Denmark [46], as mentioned in Table 1.…”