Tranexamic acid (TXA) has been popularized as an adjunct to decrease the risk of bleeding and subsequent bruising and edema in aesthetic surgery. The most notable risks of TXA are thrombus and seizures, which are associated with higher plasma concentrations. In an effort to mitigate these risks, surgeons have begun using TXA locally; either as a topical irrigation or mixed into the local anesthetic. While local use is thought to be safer from a side effect standpoint, as there is decreased systemic absorption, its use is not without risk. We present 4 patients who developed wound healing complications thought to be related to locally administered TXA. One patient had TXA delivered topically, and 3 patients had TXA mixed into their local anesthetic. These adverse events have not been published in the literature previously. This case report serves as a warning to other surgeons about using locally administered TXA.
We present a case of a 53-year-old female patient who was treated with 5-Fluorouracil (5-FU) after postsurgical contracture. A review of the literature regarding the use of 5-FU injections as a minimally invasive way to treat contracture was performed. We describe that the use of 5-FU injections is the preferred method for the effective treatment of contracture with minimal risk to the patient.
The continual advent of novel injectables has broadened the potential applications and use for facial aesthetics immensely. There are inherent risks and limitations in predictability associated with any product that is injected freely into human tissues that may possess bioreactivity. This article seeks to elucidate the most commonly feared complications as well as minor complications often overlooked by practitioners. The author also discusses the corresponding appropriate treatments.
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