What it means for a patient
- Tranexamic acid applied in the face lift wound was linked to about one third the odds of a hematoma compared with controls.
- Less blood loss and less drain fluid in the first day were also seen.
- Ask your surgeon whether they use local TXA and how.
- Limits: only 7 studies; bias was rated with a tool for non-randomized studies; the abstract gives no absolute hematoma rates, TXA doses or methods of application.
Why this paper matters
It gives pooled evidence that local TXA lowers hematoma risk in face lift surgery, the operation's most frequent complication. It supports local TXA for bleeding control in face lift, within the limits of the included studies.
Overview
Hematoma is the most frequent and consequential complication of rhytidectomy. The authors pooled studies comparing tranexamic acid (TXA) applied locally with a control in adults having a face lift. They searched PubMed, Embase, MEDLINE (EBSCO) and CENTRAL through December 2025, combined results with a random-effects model, rated bias with ROBINS-I, and rated certainty with GRADE.
Findings
- 7 studies; 1122 patients: 596 local TXA, 526 controls.
- Estimated blood loss: standardized mean difference -4.53 (95% CI, -8.09 to -0.97; P = 0.01).
- 24-hour drain output: standardized mean difference -1.10 (95% CI, -1.40 to -0.79; P < 0.01).
- Hematoma: odds ratio 0.35 (95% CI, 0.15-0.81; P = 0.014).
- The authors conclude local TXA improves surgical efficiency and patient safety by reducing blood loss, drain output and bleeding complications.
- The abstract does not give the GRADE certainty rating or safety events.
Terms
- Tranexamic acid (TXA): a drug that slows the breakdown of blood clots, reducing bleeding.
- Local administration: applying or injecting the drug in the surgical area rather than into a vein.
- Hematoma: a collection of blood under the skin after surgery.
- Meta-analysis: a method that pools results from several studies into one estimate.
- Odds ratio: a comparison of how likely an event is in one group versus another; below 1 means less likely.
- Standardized mean difference: a measure of the size of a difference between groups, on a common scale.
- 95% confidence interval (CI): the range where the true value is likely to fall.
- Random-effects model: a pooling method that allows the true effect to vary between studies.