Tranexamic Acid in Breast Esthetic Surgery.

Tranexamic acid (TXA) treatment is increasingly emphasized in plastic surgery because TXA inhibits fibrinolysis. Increased clot stability offers the possibility of preventing blood loss (prevention) and mitigating ongoing hemorrhage. TXA therapy has been principally studied in populations; the results of studies in plastic surgery still need to be improved.

Tranexamic acid is an antifibrinolytic agent that acts as a competitive inhibitor at the lysine binding sites of plasminogen and inhibits the ability of protease plasmin to cleave the fibrin clot. In large randomized controlled trials, it has been reported to be effective in decreasing perioperative blood loss in various circumstances, primarily involving trauma patients.

The investigators designed a randomized placebo-controlled trial comparing TXA dosing before incision for breast esthetic surgery. The purpose is to quantify blood loss during plastic surgery with and without TXA.

Inclusion criteria

• women scheduled for breast esthetic surgery
• ASA 1 or 2
• age >18 and <75 years

Exclusion criteria

• BMI <20 or >35 kg/m2
• ASA 3 or > 3
• medical history of thromboembolism
• history of hematological disease
• treatment with aspirin 14 days before the procedure
• treatment with anticoagulants 5 days before the procedure
• epilepsy
• allergy to tranexamic acid
• coagulation disorders