Optimizing Liposuction with Tranexamic Acid in Tumescence: A Double-Blind, Contralateral, Randomized Clinical Trial

Conventional liposuction techniques involve visible incisions and scars. Newer methods offer less invasive options with improved patient satisfaction and fewer complications. Use of tranexamic acid (TXA) in tumescent solution has shown promise in reducing bleeding and bruising, enhancing postoperative outcomes. The purpose of this study was to describe TXA's effects in edema, ecchymosis, and pain in patients undergoing arm liposuction.

A comparative contralateral randomized clinical trial was conducted at a single specialized plastic surgery institution in Bogotá, Colombia, from May of 2022 to February of 2024. The study involved adult patients aged 18 to 60 years undergoing arm liposuction, either alone or in combination with other procedures. Patients received TXA in 1 arm, and placebo in the contralateral arm, with random assignment and blinding for both patients and surgeons.

The authors' study included 78 patients, resulting in 156 arms undergoing arm liposuction with either TXA or placebo. Most patients were female (78.2%), with a mean age of 37.6 years and a mean body mass index of 24.7 kg/m². Pain scores and ecchymosis were significantly lower in the TXA arm compared with the placebo arm on the first day after the procedure. No differences in arm circumference measurements were found between groups along the different time points. The overall complication rate was 8.97%. Adding TXA to tumescent solution for arm liposuction significantly reduces pain and bruising, improving patient recovery. Our randomized trial confirms TXA's safety and effectiveness, highlighting its potential as a valuable tool in body contouring procedures and postoperative care.