Skip to main content

Advertisement

SpringerLink
Log in

Influence of Tranexamic Acid in Body Contouring Surgery: Significant Changes on Complication Rates after Abdominoplasty

  • Original Article
  • Body Contouring
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Complications after abdominoplasty remain an unsolved issue in body contouring surgery. The antifibrinolytic drug tranexamic acid (TXA) has gained increasing recognition as a valuable pharmacologic agent within plastic surgery. The aim of this study was to investigate the influence of intravenously administered TXA on complications and patient safety after abdominoplasty.

Methods

Within this retrospective single-center study, patients who underwent abdominoplasty and received intravenous TXA were selected and compared to randomly selected patients who underwent abdominoplasty without administration of TXA. The patient population was divided into two study groups (TXA vs no TXA). Demographic and surgical data as well as complications were evaluated and compared. Appropriate statistical analysis was performed.

Results

Fifty-seven female and 3 male patients with a median age of 38 years and a mean BMI of 25.6 ± 3.3 kg/m2 were included in the study. Except smoking history, demographic data showed no statistically significant differences between both groups. The most common complication was seroma formation (n = 16; 23.9%), and its occurrence was statistically significantly lower in the TXA group (p = 0.023). Furthermore, postoperative seroma aspiration was performed in statistically significant lower numbers in the TXA group (p < 0.05). No thromboembolic events or seizures were observed.

Discussion

The outcomes of this study showed that the intravenous administration of TXA leads to a significant reduction of seroma formation and postoperative seroma aspiration after abdominoplasty. Simultaneously, no adverse thromboembolic events were detected. Hence we would recommend administration of TXA in body contouring surgery to decrease the incidence of seroma formation.

Level of Evidence IV

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

TXA:

Tranexamic acid

MWL:

Massive weight loss

References

  1. ISAPS (2022) ISAPS report 2022

  2. Aesthetic Society (2022) Aesthetic plastic surgery national databank: statistics 2020–2021. Aesthet Surg J 42(Suppl 1):1–18. https://doi.org/10.1093/asj/sjac116

    Article  Google Scholar 

  3. Michaels J, Coon D, Rubin JP (2011) Complications in postbariatric body contouring: strategies for assessment and prevention. Plast Reconstr Surg 127(3):1352–1357. https://doi.org/10.1097/PRS.0b013e3182063144

    Article  CAS  PubMed  Google Scholar 

  4. Almutairi K, Gusenoff JA, Rubin JP (2016) Body contouring. Plast Reconstr Surg 137(3):586e–602e. https://doi.org/10.1097/prs.0000000000002140

    Article  CAS  PubMed  Google Scholar 

  5. Parvizi D, Friedl H, Wurzer P et al (2015) A multiple regression analysis of postoperative complications after body-contouring surgery: a retrospective analysis of 205 patients: regression analysis of complications. Obes Surg 25(8):1482–1490. https://doi.org/10.1007/s11695-014-1559-5

    Article  CAS  PubMed  Google Scholar 

  6. Stewart KJ, Stewart DA, Coghlan B, Harrison DH, Jones BM, Waterhouse N (2006) Complications of 278 consecutive abdominoplasties. J Plast Reconstr Aesthet Surg 59(11):1152–1155. https://doi.org/10.1016/j.bjps.2005.12.060

    Article  CAS  PubMed  Google Scholar 

  7. Neaman KC, Armstrong SD, Baca ME, Albert M, Vander Woude DL, Renucci JD (2013) Outcomes of traditional cosmetic abdominoplasty in a community setting: a retrospective analysis of 1008 patients. Plast Reconstr Surg 131(3):403e–410e. https://doi.org/10.1097/PRS.0b013e31827c6fc3

    Article  CAS  PubMed  Google Scholar 

  8. Kim J, Stevenson TR (2006) Abdominoplasty, liposuction of the flanks, and obesity: analyzing risk factors for seroma formation. Plast Reconstr Surg 117(3):771–773. https://doi.org/10.1097/01.prs.0000200056.57357.3f

    Article  CAS  Google Scholar 

  9. Mohammad JA, Warnke PH, Stavraky W (1998) Ultrasound in the diagnosis and management of fluid collection complications following abdominoplasty. Ann Plast Surg 41(5):498–502. https://doi.org/10.1097/00000637-199811000-00008

    Article  CAS  PubMed  Google Scholar 

  10. Seretis K, Goulis D, Demiri EC, Lykoudis EG (2017) Prevention of seroma formation following abdominoplasty: a systematic review and meta-analysis. Aesthet Surg J 37(3):316–323. https://doi.org/10.1093/asj/sjw192

    Article  PubMed  Google Scholar 

  11. Araco A, Sorge R, Overton J, Araco F, Gravante G (2009) Postbariatric patients undergoing body-contouring abdominoplasty: two techniques to raise the flap and their influence on postoperative complications. Ann Plast Surg 62(6):613–617. https://doi.org/10.1097/SAP.0b013e3181856d85

    Article  CAS  PubMed  Google Scholar 

  12. Bercial ME, Sabino Neto M, Calil JA, Rossetto LA, Ferreira LM (2012) Suction drains, quilting sutures, and fibrin sealant in the prevention of seroma formation in abdominoplasty: which is the best strategy? Aesthet Plast Surg 36(2):370–373. https://doi.org/10.1007/s00266-011-9807-8

    Article  Google Scholar 

  13. Pollock H, Pollock T (2000) Progressive tension sutures: a technique to reduce local complications in abdominoplasty. Plast Reconstr Surg 105(7):2583–2588. https://doi.org/10.1097/00006534-200006000-00047

    Article  CAS  PubMed  Google Scholar 

  14. Baroudi R, Ferreira CA (1998) Seroma: how to avoid it and how to treat it. Aesthet Surg J 18(6):439–441. https://doi.org/10.1016/s1090-820x(98)70073-1

    Article  CAS  PubMed  Google Scholar 

  15. Saldanha OR, Pinto EB, Matos WNJ, Lucon RL, Magalhães F, Bello EM (2001) Lipoabdominoplasty without undermining. Aesthet Surg J 21(6):518–526. https://doi.org/10.1067/maj.2001.121243

    Article  CAS  PubMed  Google Scholar 

  16. Ng W, Jerath A, Wąsowicz M (2015) Tranexamic acid: a clinical review. Anaesthesiol Intensive Ther 47(4):339–350. https://doi.org/10.5603/AIT.a2015.0011

    Article  PubMed  Google Scholar 

  17. Wang S, Yang J, Lin L (2023) Intravenous application of tranexamic acid in patients undergoing plastic surgery: a systematic review and meta-analysis with GRADE quality assessment. Aesthet Plast Surg. https://doi.org/10.1007/s00266-023-03637-z

    Article  Google Scholar 

  18. Ker K, Prieto-Merino D, Roberts I (2013) Systematic review, meta-analysis and meta-regression of the effect of tranexamic acid on surgical blood loss. Br J Surg 100(10):1271–1279. https://doi.org/10.1002/bjs.9193

    Article  CAS  PubMed  Google Scholar 

  19. Ker K, Roberts I (2014) Tranexamic acid for surgical bleeding. BMJ 349:g4934. https://doi.org/10.1136/bmj.g4934

    Article  CAS  PubMed  Google Scholar 

  20. White N, Marcus R, Dover S et al (2009) Predictors of blood loss in fronto-orbital advancement and remodeling. J Craniofac Surg 20(2):378–381. https://doi.org/10.1097/SCS.0b013e31819b9429

    Article  PubMed  Google Scholar 

  21. Brown S, Yao A, Taub PJ (2018) Antifibrinolytic agents in plastic surgery: current practices and future directions. Plast Reconstr Surg 141(6):937e–949e. https://doi.org/10.1097/PRS.0000000000004421

    Article  CAS  PubMed  Google Scholar 

  22. Jimenez JJ, Iribarren JL, Lorente L et al (2007) Tranexamic acid attenuates inflammatory response in cardiopulmonary bypass surgery through blockade of fibrinolysis: a case control study followed by a randomized double-blind controlled trial. Crit Care 11(6):R117. https://doi.org/10.1186/cc6173

    Article  PubMed  PubMed Central  Google Scholar 

  23. Salari N, Fatahi B, Bartina Y et al (2021) The global prevalence of seroma after abdominoplasty: a systematic review and meta-analysis. Aesthet Plast Surg 45(6):2821–2836. https://doi.org/10.1007/s00266-021-02365-6

    Article  Google Scholar 

  24. Ardehali B, Fiorentino F (2017) A meta-analysis of the effects of abdominoplasty modifications on the incidence of postoperative seroma. Aesthet Surg J 37(10):1136–1143. https://doi.org/10.1093/asj/sjx051

    Article  PubMed  Google Scholar 

  25. Macias LH, Kwon E, Gould DJ, Spring MA, Stevens WG (2016) Decrease in seroma rate after adopting progressive tension sutures without drains: a single surgery center experience of 451 abdominoplasties over 7 years. Aesthet Surg J 36(9):1029–1035. https://doi.org/10.1093/asj/sjw040

    Article  PubMed  Google Scholar 

  26. Agha-Mohammadi S, Hurwitz DJ (2008) Potential impacts of nutritional deficiency of postbariatric patients on body contouring surgery. Plast Reconstr Surg 122(6):1901–1914. https://doi.org/10.1097/PRS.0b013e31818d20d6

    Article  CAS  PubMed  Google Scholar 

  27. Light D, Arvanitis GM, Abramson D, Glasberg SB (2010) Effect of weight loss after bariatric surgery on skin and the extracellular matrix. Plast Reconstr Surg 125(1):343–351. https://doi.org/10.1097/PRS.0b013e3181c2a657

    Article  CAS  PubMed  Google Scholar 

  28. Baptista LS, da Silva KR, da Pedrosa CSG et al (2009) Adipose tissue of control and ex-obese patients exhibit differences in blood vessel content and resident mesenchymal stem cell population. Obes Surg 19(9):1304–1312. https://doi.org/10.1007/s11695-009-9899-2

    Article  PubMed  Google Scholar 

  29. De Paep K, Van Campenhout I, Van Cauwenberge S, Dillemans B (2021) Post-bariatric abdominoplasty: identification of risk factors for complications. Obes Surg 31(7):3203–3209. https://doi.org/10.1007/s11695-021-05383-0

    Article  PubMed  Google Scholar 

  30. Wokes JET, Erdmann MWH, McLean NR (2021) The role of tranexamic acid in aesthetic plastic surgery: a survey of the British Association of Aesthetic Plastic Surgeons. Aesthet Surg J 41(2):244–249. https://doi.org/10.1093/asj/sjaa149

    Article  PubMed  Google Scholar 

Download references

Funding

The authors received no financial support for the research, authorship, and publication of this article.

Author information

Authors and Affiliations

  1. Section of Plastic and Reconstructive Surgery, Kepler University Hospital Linz, Krankenhausstrasse 9, 4020, Linz, Austria

    Maximilian Zaussinger, Celina Kerschbaumer, Kathrin Bachleitner, Gudrun Ehebruster & Manfred Schmidt

  2. Medical Faculty, Johannes Kepler University Linz, Altenberger Straße 69, 4040, Linz, Austria

    Maximilian Zaussinger & Manfred Schmidt

  3. Doctoral Degree Program in Medical Science, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria

    Maximilian Zaussinger

  4. Department of Research and Development, University of Applied Sciences for Health Professions Upper Austria, Semmelweisstraße 34, D3, 2, 4020, Linz, Austria

    Bernhard Schwartz

Authors
  1. Maximilian Zaussinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Celina Kerschbaumer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bernhard Schwartz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kathrin Bachleitner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gudrun Ehebruster
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Manfred Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maximilian Zaussinger.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

All patients gave written and verbal informed consent of attendance.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zaussinger, M., Kerschbaumer, C., Schwartz, B. et al. Influence of Tranexamic Acid in Body Contouring Surgery: Significant Changes on Complication Rates after Abdominoplasty. Aesth Plast Surg (2024). https://doi.org/10.1007/s00266-024-04094-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00266-024-04094-y

Keywords

Search

Navigation