Transexamic Acid (Txa) use to prevent bruising-experience and risk?

Question

I am considering a facelift/neck lift/brow lift and I am concerned about the bruising and swelling. I bruise very easily. A friend of mine just got a facelift in San Francisco from a Doctor who uses TXA to prevent bruising. She hardly had any bruising and swelling. Can I request this from my doctor? What is your experience? Risks? Is there something better?

Jeffrey M. Darrow, MD · Answer

Bruising can occur after any facial surgery. It should be minimized as much as possible.  The best way to minimize bruising is to have meticulous surgical technique and hemostasis.  Tax is used as an adjunct to surgical technique but would not take the place of careful hemostasis.  I presently do not have any experience with Txa because I am extremely careful about my hemostasis before closing my incisions and have minimal bruising. I don’t believe that there are any specific risks to Txa nor am I aware that there are other better alternatives.  Best wishes.

Jaime Haidenberg, MD · Answer

Hi, thank you for your question. We routinely use TXA for our facelifts and the incidence of postoperative bruising and hematomas is very low. It's a great product that is used in multiple surgical procedures to prevent bleeding during and after the procedure. There is basically no risks of using TXA during a facelift. It is important though, that you use a surgeon with a lot of experience doing facelifts, since this is just an adjunct to the actual procedure. Good luck!

Cory Bovenzi, MD · Answer

TXA is a great medication to decrease bruising and is more and more commonly used in cosmetic surgery. I use it in all of my facelifts and think it makes a good improvement. Using perioperative arnica and bromelain supplements can also help, as well as discontinuing supplements that "thin your blood" like fish oil, turmeric, etc. It is a fair question to ask your surgeon if they use TXA, but as it is a newer addition to the field, not every surgeon has adopted it into their practice yet.

Richard Baxter, MD · Answer

We routinely add TXA to the local anesthetic for our facelifts, and it does seem to help minimize the swelling and bruising. It is very safe when done this way.

Gerald Minniti, MD, FACS · Answer

There is so much more than TXA that can affect bruising. In other words, people can still have a lot of bruising with TXA. The data is clear that it is safe and it's benefit is minimizing intra-operative bleeding, allowing the surgeon to concentrate on the task at hand and not distracted with stopping the bleeding. The key to a good result is the experience of the surgeon, not the use of TXA.

Brian K. Machida, MD, FACS · Answer

TXA is something you can request but your doctor may not comply depending on his routine. I used it mixed with my tumescient injection solution for the face. It is fairly dilute and carries minimal risk from the one time use. Otherwise in its standard use for cases of heavy bleeding, it can be a 5-7 day course of oral or IV therapy.  However when used in this fashion, it is not innocuous and carries risk of vision changes, clots in the brain, lungs, or legs. Your doctor may not feel comfortable if he has not used it before, and it would be appropriate for him to refuse if beyond his comfort level.

Ronald J. Edelson, MD · Answer

I've been using TXA for about a year and have noticed the same thing. Much less bruising in facelifts and rhinoplasties. More and more surgeons are using it and it's really cheap.,$5 a dose so if you do get it don't let them charge you much of any thing now that you know what it really costs

Guy Cappuccino, MD · Answer

Hello Brisa,
I would recommend TXA with your facelift to reduce the risk of bruising.  Personally I use it with every facelift, and facial surgery I perform and find it has been very effective at reducing bleeding and bruising. If your doctor is familiar with using TXA then he/she would most likely incorporate its use.  If not, it's fine to ask about it and politely request it for your surgery.

Richard Wellington Swift, MD · Answer

Thank you for posting your interesting question about TXA minimizing brusing with facelifts.In addition to excellent surgical technique, the addition of TXA can minimize post operative bruising in face and neck lifts. Adding the homeopathic Arnica Montana, which is found at the heath food stores, can also help minimize bruising. I recommend that you have a consultation with a Board Certified Plastic Surgeon who is experienced with facelifts. Best wishes, Richard Wellington Swift, M.D., F.A.C.S.

William Portuese, MD · Answer

Every drug has an effect and a side effect, so it's important to look at the side effects and whether or not that put you at any increased risk for issues. This should be performed by your surgeon. TXA is not for everybody. In our practice, place Jackson Pratt drain's in the forehead and neck to significantly reduce the bruising and are left in place for 1 to 2 days. That way the drains remove the blood for out from underneath the skin and significantly reduce any bruising

Transexamic Acid (Txa) use to prevent bruising-experience and risk?

Answers (12)

More Facelift Questions

Is Botox before Facelift consultation and surgery okay?

How painful is a facelift under local anesthesia?

48 years old - is a surgical lift jumping the gun? (photos)

Is it time for a facelift, lower/upper blepharoplasty and TCA Peel? (Photos)

Why do you never see before and after pics of the underside of a patient's neck pre and post facelift?

WE SEND PRETTY
EMAILS