Use of Tranexamic Acid in Labiaplasty Surgery
Labiaplasty has quickly become a popular cosmetic procedure sought after by women. Hematoma is the most common acute post-operative complication of this procedure, while ecchymosis is expected in all patients who undergo this procedure due to the vascularity within and around the labia. Tranexamic acid (TXA) is an antifibrinolytic which competitively inhibits conversion of plasminogen to plasmin. Studies have demonstrated safe outcomes, along with favorable results using intravenous, oral, local injection and topical forms of TXA in aesthetic surgery. Experience with TXA use in labiaplasty surgery has not been yet described. We sought to evaluate the efficacy of TXA at reducing post-operative hematoma and ecchymosis following labiaplasty surgery.
Methods/Technique:
All patients who were undergoing bilateral labiaplasty by a single surgeon were candidates for this study. Each patient served as their own control. The left labia minora served as the control, injected with 10 ml of local anesthesia (5 ml of 1% lidocaine with epinephrine and 5 ml of 0.25% Marcaine). TXA was included within the local anesthesia injection on the right labia minora (0.5mg TXA, 5 ml of 1% lidocaine with epinephrine and 4.5 ml Marcaine 0.25%). Patients were evaluated at post-operative day one, three (when patients are usually the most swollen and most ecchymosis present). Patients will then be seen at one- and three-weeks post procedure. Each visit will include photo documentation evaluating left and right sides for any hematoma, presence of ecchymosis, swelling and subsequently pain. Standardized pain score will be utilized for patients to document their pain levels.
Results/Complications:
This is an ongoing study in the finishing stages, with expected total of 25-30 patients. Patient demographics, operative time and any intraoperative complications were recorded. Ecchymosis and hematoma rates are both subjectively and objectively evaluated and recorded. Any other complications were recorded.
Conclusion:
This is the first known study to evaluate the use of TXA in labiaplasty surgery. Local administration of TXA has great effects of reducing ecchymosis and swelling in the post-operative period following labiaplasty. This could potentially reduce the incidence of addition common complications seen with labiaplasty surgery, such as dehiscence, bubbling of skin edges along the incision and need for revision surgery. These benefits make recovery post procedure much more comfortable for the patient and increases their satisfaction in your work.