The Esthetic Clinics (TEC®️), one of India’s leading multi-speciality centres for cosmetic and reconstructive surgery, dermatology, and aesthetic medicine, has spearheaded a landmark systematic review and meta-analysis published in the Journal of Plastic, Reconstructive & Aesthetic Surgery (Impact Factor: 2.5), the official journal of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS). The study spotlights Tranexamic Acid (TXA) as a game-changing adjunct in facial aesthetic surgery, consolidating data from 22 high-quality studies with data from over 9,000 patients across a 20-year span, making it the most comprehensive review of TXA’s role in aesthetic surgery to date.
Originally used in trauma care and orthopaedic surgeries — and more widely known for treating heavy menstrual bleeding — TXA has now shown significant promise in enhancing outcomes in facial cosmetic procedures such as rhinoplasty, rhytidectomy (facelift), and blepharoplasty (eyelid surgery). The study revealed that TXA administration — whether intravenous, topical, oral, or through local infiltration — consistently resulted in:
- Reduced intraoperative blood loss
- Shorter surgical duration
- Lower postoperative swelling (oedema)
- Decreased bruising (ecchymosis)
- Reduced drain output
Importantly, these benefits were achieved without an increase in adverse events, reaffirming TXA’s safety profile even across different delivery methods and patient populations.
“This review elevates Tranexamic Acid from a supplementary option to a strong candidate for standard use in facial aesthetic surgery,” said Dr Debraj Shome, Director, The Esthetic Clinics® and the senior author of the study. “With consistent, high-quality evidence from over 9,000 patients across 22 studies, TXA demonstrates clear clinical value. While final treatment decisions must always be patient- and context-specific, these findings provide a compelling case for its broader consideration in surgical protocols worldwide.”
The study further highlights the synergistic benefits of combining TXA with local anaesthetic agents such as lidocaine and epinephrine. This combination was found to not only enhance hemostasis and reduce operative time but also prolong the duration of local anaesthesia.
While results were promising across all included studies, the authors have called for standardised dosing regimens and outcome grading systems to support consistent and safe implementation globally. The review also outlines key areas for future research, including long-term safety data and optimal administration strategies.
This milestone study is expected to influence global surgical guidelines and elevate postoperative care standards in aesthetic practices.
