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Local Infiltration of Tranexamic Acid During Facelift Improves Operating Room Efficiency: a Matched Patient Study
Demetrius M. Coombs, MD; Grzegorz J. Kwiecien, MD; Nicholas R. Sinclair, MD; Alison Jin, MS; James E. Zins, MD, FACS
The Cleveland Clinic
2022-01-31
Presenter: Demetrius Coombs
Affidavit:
The work on this project represents the original work of the resident.
Director Name: Steven L Bernard, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background: Tranexamic acid (TXA) has rapidly gained popularity in aesthetic surgery. Previous reports have suggested that TXA provides a dry surgical field and significantly reduces operating time during facelift surgery.
Objectives: In this study we build upon these findings by providing a large cohort matched alongside historic controls and more clearly document time saved when performing facelift surgery.
Methods: Retrospective, single-surgeon case-control study from July 2016 to October 2021. All patients underwent facelift surgery alone or in combination with fat transfer and perioral chemical peel. All patients received subcutaneous infiltration of 0.5% lidocaine/1:200:000 epinephrine with or without 1-2mg/mL TXA. Patient demographics, TXA dose, surgical time, minor and major complications were examined.
Results: One-hundred forty-five consecutive patients were identified: 73 in Group 1 (no-TXA) and 72 in Group 2 (TXA). No differences in terms of gender distribution (p=0.75), age (p=0.54), BMI (p=0.18), frequency of secondary rhytidectomy (p=0.08), rate of ancillary lipografting (p=0.44), TXA dose (p=0.238), and minor complication rate (p=0.56) were observed. However, mean surgical time in the no-TXA group was 21 minutes longer than the TXA group (p=0.016). Six patients (8%) in the no-TXA group experienced minor complications versus 8 patients (11%) in the TXA group. No patients experienced major complications.
Conclusions: While prior studies have highlighted the potential benefits of TXA in aesthetic surgery, much of the data remains subjective and non-validated. This report adds to the objective body of evidence supporting TXA in facial aesthetic surgery by documenting time saved in the operating room without additional surgical morbidity.
