Optimizing Liposuction with Tranexamic Acid in Tumescence: A Double-blind Contralateral Randomized Clinical Trial

Background: Conventional liposuction techniques involve visible incisions and scars. Newer methods offer less invasive options with improved patient satisfaction and fewer complications. Use of tranexamic acid (TXA) in tumescent solution has shown promise in reducing bleeding and bruising, enhancing postoperative outcomes. Purpose: Describe TXA effects in edema, ecchymosis, and pain in patients undergoing arm liposuction. Methods: A comparative contralateral randomized clinical trial was conducted at a single specialized plastic surgery institution in Bogotá, Colombia, from May 2022 to February 2024 (Clinical trial reg No. NCT06648265). The study involved adult patients aged 18 to 60 undergoing arm liposuctions, either alone or in combination with other procedures. Patients received TXA in one arm, and placebo in the contralateral arm, with random assignment and blinding for both patients and surgeons. Results: Our study included 78 patients, resulting in 156 arms undergoing arm liposuction with either TXA or placebo. Most patients were female (78.2%), mean age of 37.6 years, mean BMI 24.7 kg/m². Pain scores and Ecchymosis were significantly lower in the TXA arm compared to placebo arm on the first day post-procedure. No differences on arm circumference measurements were found between groups along the different time points. Overall complication rate was 8.97%, unrelated to arm liposuction or TXA use. Conclusions: Adding tranexamic acid to tumescent solution for arm liposuction significantly reduces pain and bruising, improving patient recovery. Our randomized trial confirms TXA’s safety and effectiveness, highlighting its potential as a valuable tool in body contouring procedures and postoperative care.