Quick blog, because if you read my blogs enough, you know I am a fan of TXA in surgery.
TXA (Tranexamic Acid) is a lysine which reduces fibrin clot break ups- in English this means it reduces postoperative bruising and swelling and reduces blood transfusion rates seen in surgical fields with big blood loss- cardiac surgery, trauma, OBGyne, and orthopedic surgery. It has NOT been shown to increase DVT risk.
In facelifts, it has been thought to help by reducing intraoperative bleeding, which therefore reduces the operative time and wound drainage. But a report by a well respected facelift plastic surgeon raised concerns about a possible link between TXA and wound healing.
This is a published study in the Aethetic Surgery Journal, December 2025. “Local Tranexamic Acid in Facelift Surgery Is Not Associated With Wound Healing Complications: A Matched, Single Surgeon Cohort Study.” From the title, you know what they found. But the study is good in that it was looking objectively at a large number of facelifts- did TXA make a difference? Good or bad?
Study:
They conclude, “In patients undergoing facelift procedures with wide skin undermining, TXA appears safe when used with appropriate dosing, screening, and technique.
I liked this study. I heard the other surgeon who is very well-respected state he doesn’t use TXA, and I am sure that had a ripple effect in my community. Interesting tidbits for me:
How to give TXA and the amount to give are being honed. IV? in the irrigation? In the local anesthetic? Will keep an eye on the data. But I am a fan.
Local Tranexamic Acid in Facelift Surgery Is Not Associated With Wound Healing Complications: A Matched, Single-Surgeon Cohort Study, Aesthetic Surgery Journal December 2025
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