TY - JOUR
T1 - Intravenous Versus Subcutaneous Tranexamic Acid in Liposuction
T2 - A Comparative Analysis of Efficacy and Safety
AU - Al-Khafaji, Mustafa Qais
AU - Mehta, Aashna
AU - Halawani, Ibrahim R.
AU - Vivek, Joel Edassery
AU - George, Kenneth Joshua
AU - Ali, Syed Hasham
AU - Al-Khafaji, Shahad Qais
AU - Pluzsnyik, Édua
AU - Al-Khafaji, Yousif Qais
AU - Al-Khafaji, Murtadha Qais
AU - Ali, Raja Adil
AU - Alabdulkarim, Abdulaziz
N1 - Publisher Copyright:
© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2025.
PY - 2025/11
Y1 - 2025/11
N2 - Background: Liposuction is among the most carried-out aesthetic procedures in the world and is usually associated with considerable intraoperative blood loss. Tranexamic acid is an antifibrinolytic agent commonly used to minimize blood loss during surgery. However, there is scant evidence regarding the comparative efficacy and safety of intravenous administration versus subcutaneous administration during liposuction. Methods: PRISMA guidelines were followed for this systematic review and meta-analysis. A total of 10 studies that investigated TXA in liposuction published from 2000 to 2024 were identified from the overall search across PubMed, Google Scholar, and Ovid. Main outcomes evaluated the changes in hematologic parameters (hemoglobin and hematocrit), perioperative blood loss, and postoperative complications. Random-effects models and network meta-analyses comparing IV and SC routes of administration were conducted. Results: TXA significantly reduced intraoperative blood loss and improved postoperative hematologic stability. IV TXA proved to be more effective with a decrease in hematocrit change than SC (MD − 2.43, 95% CI [− 3.84, − 1.03]) and placebo (MD − 3.06, 95% CI [− 4.36, − 1.76]), while SC TXA showed a significant improvement in postoperative hemoglobin levels (MD 0.54, 95% CI [0.07, 1.01]). Both routes were associated with low complication rates, and no thromboembolic event was noted in either group. Conclusion: TXA is effective in reducing blood loss during liposuction, with IV administration showing greater hematologic stabilization. SC administration remains a safe and viable alternative. Further high-quality trials are needed to refine dosing strategies and explore long-term outcomes. Level of Evidence II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
AB - Background: Liposuction is among the most carried-out aesthetic procedures in the world and is usually associated with considerable intraoperative blood loss. Tranexamic acid is an antifibrinolytic agent commonly used to minimize blood loss during surgery. However, there is scant evidence regarding the comparative efficacy and safety of intravenous administration versus subcutaneous administration during liposuction. Methods: PRISMA guidelines were followed for this systematic review and meta-analysis. A total of 10 studies that investigated TXA in liposuction published from 2000 to 2024 were identified from the overall search across PubMed, Google Scholar, and Ovid. Main outcomes evaluated the changes in hematologic parameters (hemoglobin and hematocrit), perioperative blood loss, and postoperative complications. Random-effects models and network meta-analyses comparing IV and SC routes of administration were conducted. Results: TXA significantly reduced intraoperative blood loss and improved postoperative hematologic stability. IV TXA proved to be more effective with a decrease in hematocrit change than SC (MD − 2.43, 95% CI [− 3.84, − 1.03]) and placebo (MD − 3.06, 95% CI [− 4.36, − 1.76]), while SC TXA showed a significant improvement in postoperative hemoglobin levels (MD 0.54, 95% CI [0.07, 1.01]). Both routes were associated with low complication rates, and no thromboembolic event was noted in either group. Conclusion: TXA is effective in reducing blood loss during liposuction, with IV administration showing greater hematologic stabilization. SC administration remains a safe and viable alternative. Further high-quality trials are needed to refine dosing strategies and explore long-term outcomes. Level of Evidence II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
KW - Blood loss
KW - Intravenous TXA
KW - Liposuction
KW - Subcutaneous TXA
KW - Tranexamic acid
UR - https://www.scopus.com/pages/publications/105013975354
U2 - 10.1007/s00266-025-05173-4
DO - 10.1007/s00266-025-05173-4
M3 - Review article
AN - SCOPUS:105013975354
SN - 0364-216X
VL - 49
SP - 6089
EP - 6103
JO - Aesthetic Plastic Surgery
JF - Aesthetic Plastic Surgery
IS - 21
ER -