Study Compares TXA Delivery Methods in Rhinoplasty Outcomes

In a prospective comparative study published online ahead of print in Journal of Craniofacial Surgery, investigators evaluated the impact of different tranexamic acid (TXA) administration routes on postoperative recovery following implant-based rhinoplasty. A total of 82 patients undergoing primary procedures were assigned to 1 of 4 groups: no TXA (control), local injection, topical intraoperative application via soaked gauze, or intravenous administration.

Postoperative outcomes included edema, ecchymosis, pain scores, and time to social recovery, assessed on postoperative day (POD) 1, 3, 7, and 1 month. Significant differences emerged in early recovery across groups. Patients receiving topical TXA demonstrated the lowest edema and ecchymosis scores on POD1 and POD3, followed by local injection and intravenous administration, while control patients had the poorest outcomes. By POD7, all TXA-treated groups showed improvement compared with controls; however, local administration remained more effective than intravenous delivery.

Time to social recovery was shortest in the topical TXA group, suggesting a potential benefit in reducing downtime after aesthetic procedures. Pain outcomes were assessed but not detailed in the abstract, limiting interpretation of analgesic effects. By 1 month, no clinically meaningful differences were observed among groups, indicating that TXA’s benefits are confined to early healing.

Study limitations include a modest sample size and lack of detailed reporting on pain outcomes and potential adverse events.

“Local administration of TXA, particularly topical intraoperative application, significantly improves early postoperative recovery following implant-based rhinoplasty,” the authors wrote. “These benefits appear to be limited to the early postoperative period, with no impact on long-term outcomes. Topical TXA represents a simple and effective adjunct for enhanced recovery in aesthetic rhinoplasty.”