What is TXA?
TXA is Tranexamic Acid. It started being used in medicine in Trauma and Ortho surgery where blood loss was larger, and they found it helped improved survival and blood loss. TXA is a synthetic derivative of lysine (an amino acid) which helps block the breakdown of fibrin clots. What does this mean in English? It means that it helps to stabilize blood clots which helps lower bleeding and bruising during and after surgery.
What is the potential negative of TXA?
Anything that prevents bleeding could increase blood clots. During a surgery, we do everything we can to avoid a certain kind of blood clot, called a deep vein thrombosis. This can lead to pulmonary embolisms, which can cause major problems and even death.
TXA STUDIES HAVE SHOWN NO INCREASE IN DVTs.
How do we use TXA in plastic surgery?
TXA use in plastic surgery has grown in the past couple years after we have seen the benefits in other surgical fields and the safety of use. Anytime we do a bigger surgery- breast reduction, tummy tuck, body liposuction- it tends to be used. You can use it IV, in the irrigation, or topically. Please see my TXA blogs TXA BLOGS
New Aesthetic Surgery Journal Study on TXA in body contouring
This is a published Systematic Review and Meta Analysis in the Aesthetic Surgery Journal, October 2025. “Tranexamic Acid in Body Contouring Surgery: A Systematic Review and Meta Analysis.”
In this they looked at breast and body contouring surgery papers addressing TXA use. 13 studies were analyzed.
Study:
- Meta analysis of complications following TXA- hematoma, seroma, infection, wound healing issues.
- They did subgroups based on how it was given- IV, topical, or IV and topical
- Findings? Significant lower risk of hematoma. (no difference in seroma or wound healing)
- In the subgroup with topical TXA, they found significant reduction in infection.
In their discussion, they found TXA significantly decreased hematoma formation in breast surgery. Other surgical specialties have studies showing TXA can mitigate excessive bleeding and associated complications. They postulate TXA helps avoid infections by not having blood collections, which would be a medium for bacterial growth. There was a recent animal study showing TXA prevented biofilm production. (I haven’t seen that and yay! I use TXA in my irrigation for breast augmentation patients already). Other studies show earlier drain removal and lower drain output.
Dr. Greenberg’s thoughts on TXA
I use TXA in most of my cases. I have many blogs on the subject, and I think the science is sound, safe, and compelling. I do feel overall that my patients have less bruising, and when I use drains, like in my tummy tucks, I feel drains come out quickly. (But I also use progressive tension quilting sutures, cautery, garments, and other techniques to reduce drain output).
Bottom line, I am a fan.
Medical Citation & blog links
Tranexamic Acid in Body Contouring Surgery: A Systematic Review and Meta-Analysis – PMC, Aesthetic Surgery Journal October 2025
The information provided on this website is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider for any questions regarding your health or medical condition.
