Table 3.
TXA in Facelift
| Authors | Journal and Year | Study Design | Study Group (Total No.) | Surgery Type | Administration Mode and Dosage | Main Clinical Outcome | Main Results | Complications Related to TXA |
|---|---|---|---|---|---|---|---|---|
| Butz et al | PRS Global Open 2016 | Case series | 57 (57)47 women and 10 menMean age: 61.9 y | Rhytidectomy with SMAS plication | TOPIC: TXA-soaked pledgets placed under the skin flapDosage N/A | Intra- and postoperative bleedingComplications | Subjective reduction of edema, ecchymosis, and faster return to social activity1 hematoma reported | None |
| Couto et al | Aesthetic Surgery Journal 2019 | RC | 27 (27)100% womenMean age: 62.1 y | 85% extended deep plane facelift and 15% rhytidectomy with SMAS plication 100% with neck lift | LOCAL: 1.5 mL of 100 mg/mL TXA in 150 mL of 0.5 % lidocaine with 1:200,000 epinephrine for a final concentration of 1 mg of TXA/1 mL of local anesthetic. In total, 60 mL of this solution 15 min before incision. | Time to gain hemostasis | Reduction in time to gain hemostasisNo intraoperative or postoperative hematomas or seromas | None |
| Cohen et al | Aesthetic Surgery Journal 2020 | RCT | 27 (44)100% womenMean age: 59 y | Extended deep-plane facelift | EV bolus: 1 g of TXA before skin incision, and 4 hours later | Intraoperative bleedingPostoperative ecchymosis and edema | Significant decrease in postoperative collectionsStatistically significant decrease in surgeon- rated bruising | None |
| Schroeder II et al | Facial Plastic Surgery & Aesthetic Medicine 2020 | RC | 44 (76)100% womenMean age: 61.5 y | Deep plane rhytidectomy with platysmaplasty | LOCAL: 9.1 mg of TXA/1 mL of local and tumescent anesthetic | POD1 drain output, number of days to drain removal, percentage of drains removed POD1, and percentage of drains with <25 cm3 outputIntraoperative estimated blood lossComplications | POD1 drain output decreased by 70% (P < 0.001)Drains were more commonly being removed POD1 (P < 0.001)Intraoperative blood loss was reduced in TXA patients (P < 0.001) | Single thromboembolic event |
| Kochuba et al | Aesthetic Surgery Journal 2020 | PC | 39 (39)35 women and 4 menMean age: 64.9 y | Extended deep plane facelift or SMAS plication, or facelift surgery combined with ancillary facial rejuvenation procedures (37%) | LOCAL: 1–2 mg of TXA per 1 mL of 0.5% lidocaine with 1:200,000 epinephrine. In total, 60 mL of this solution 15 min before incision | Time to hemostasisDrain outputComplications | Reduction in time to gain hemostasisNo intraoperative or postoperative hematomas or seromas | None |
PC, prospective cohort; POD1, postoperative day 1; RC, retrospective cohort.