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Updated: May 24, 2025

Author Spotlight: Non-Surgical Treatment of Melasma&#8211; Microneedling with Tranexamic Acid
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Author Spotlight: Non-Surgical Treatment of Melasma– Microneedling with Tranexamic Acid

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Comparison of Tranexamic Acid Administration Methods in Rhytidectomy: A Prospective, Randomized, Double-blind Study.

Steven P Davison1, Molly Ellor2, Courteney Hedicke3

  • 1From the DAVinci Plastic and Reconstructive Surgery, Washington, DC.

Plastic and Reconstructive Surgery. Global Open
|March 5, 2025
PubMed
Summary
This summary is machine-generated.

Intravenous tranexamic acid (TXA) may offer advantages in facelift surgery by reducing drain removal time and improving patient satisfaction predictability compared to local administration.

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Area of Science:

  • Plastic Surgery
  • Dermatology
  • Pharmacology

Background:

  • Tranexamic acid (TXA) is an antifibrinolytic agent with potential benefits in facial rejuvenation.
  • Optimal administration method for TXA in cosmetic surgery remains undetermined.
  • This study investigates intravenous versus local tumescent TXA for rhytidectomy outcomes.

Purpose of the Study:

  • To compare the efficacy of intravenous (IV) TXA versus local tumescent TXA in facelift (rhytidectomy) surgery.
  • To evaluate differences in blood loss, patient-reported outcomes, and complication rates.
  • To determine the optimal route of TXA administration for facial rejuvenation procedures.

Main Methods:

  • Sixty rhytidectomy patients were randomized to receive either IV TXA or local tumescent TXA.
  • Intraoperative blood loss and bleeding rates were recorded.
  • Postoperative assessments included patient satisfaction, bruising, swelling, ecchymosis, edema, drain removal time, and complications.

Main Results:

  • No significant difference in intraoperative blood loss or surgeon-graded bruising and swelling between IV and local TXA groups.
  • IV TXA group showed a statistically significant decrease in days to drain removal (1.16 days vs. 2.04 days).
  • Local TXA group exhibited greater variability in patient satisfaction and drain removal time.

Conclusions:

  • Intravenous administration of TXA may offer a slight advantage in rhytidectomy.
  • IV TXA is associated with reduced time to drain removal and more consistent patient satisfaction.
  • Further research may clarify the precise benefits of IV TXA in facial cosmetic surgery.