Prabhughate Ashwin, Bellani Depti, Shome Debraj, Kapoor Rinky, Parkar Suhina, Shahare Riya
Department of Research, The Esthetic Clinics, Mumbai, Maharashtra, India.
Department of Facial Plastic Surgery and Facial Cosmetic Surgery, The Esthetic Clinics, Mumbai, Maharashtra, India.
J Plast Reconstr Aesthet Surg. 2025 Jul;106:265-275. doi: 10.1016/j.bjps.2025.05.024. Epub 2025 May 20.
Tranexamic acid (TXA) is a synthetic antifibrinolytic agent originally developed for hemostasis, which is now widely used in aesthetic and reconstructive surgery. Its application in facial cosmetic procedures is aimed at reducing bleeding, swelling, and bruising. This systematic review assesses the impact of TXA on postoperative outcomes in facial cosmetic surgery, focusing on blood loss, surgical time, edema, and ecchymosis.
This review followed the preferred reporting items for systematic reviews and meta-analyses guidelines and synthesized data from randomized controlled trials, cohort studies, and case-control studies published between 2004 and 2024. Eligible studies examined TXA in aesthetic facial surgeries (e.g., rhinoplasty, rhytidectomy, and blepharoplasty). Outcomes included intraoperative bleeding, surgical time, postoperative edema, ecchymosis, and patient satisfaction. A comprehensive search was conducted across the PubMed, Embase, Cochrane Library, and Google Scholar databases.
Twenty-two studies involving 9005 patients were included. TXA significantly reduced blood loss, postoperative edema, and ecchymosis. The average surgical time was 122.17 (SD: 34.44) min, with mean blood loss of 86.63 (SD: 56.93) cc. TXA use consistently decreased drain output and postoperative complications, particularly in rhinoplasty and rhytidectomy. Various administration routes (intravenous, topical, or local infiltration) showed no significant systemic complications. Combining TXA with local anesthetics improved hemostatic and anesthetic efficacy.
TXA is an effective adjunct in facial cosmetic surgery that reduces intraoperative bleeding, surgical time, and postoperative sequelae such as edema and ecchymosis. Further studies are needed to establish standardized dosing and objective outcome grading. TXA demonstrated safety and efficacy indicating that it should become a standard practice in facial aesthetic procedures.
氨甲环酸（TXA）是一种最初用于止血的合成抗纤维蛋白溶解剂，目前广泛应用于美容整形手术。其在面部美容手术中的应用旨在减少出血、肿胀和瘀斑。本系统评价评估了TXA对面部美容手术术后结局的影响，重点关注失血、手术时间、水肿和瘀斑。
本评价遵循系统评价和Meta分析的首选报告项目指南，综合了2004年至2024年发表的随机对照试验、队列研究和病例对照研究的数据。符合条件的研究在美容面部手术（如隆鼻术、除皱术和眼睑成形术）中检测了TXA。结局包括术中出血、手术时间、术后水肿、瘀斑和患者满意度。对PubMed、Embase、Cochrane图书馆和谷歌学术数据库进行了全面检索。
纳入了22项涉及9005例患者的研究。TXA显著减少了失血、术后水肿和瘀斑。平均手术时间为122.17（标准差：34.44）分钟，平均失血量为86.63（标准差：56.93）毫升。使用TXA持续减少引流液量和术后并发症，尤其是在隆鼻术和除皱术中。各种给药途径（静脉注射、局部外用或局部浸润）均未显示明显的全身并发症。将TXA与局部麻醉剂联合使用可提高止血和麻醉效果。
TXA是面部美容手术的一种有效辅助药物，可减少术中出血、手术时间以及水肿和瘀斑等术后后遗症。需要进一步研究以建立标准化给药方案和客观的结局分级。TXA显示出安全性和有效性，表明它应成为面部美容手术的标准操作。
