Topical Tranexamic Acid in Primary Breast Augmentation Surgery: Short- and Long-term Outcomes

Breast augmentation mammoplasty (BAM) remains to be the most popular cosmetic procedure done worldwide. Bleeding in this procedure increases the chance of capsular contracture. Tranexamic acid (TXA), an anti-fibrinolytic, has been widely used by other surgical specialties to reduce bleeding.We aimed to evaluate the use of TXA in BAM surgery.This is a single-surgeon case series of all patients who underwent primary BAM from March 2017 to March 2018 and received topical TXA spray to the implant pocket prior to implant insertion. Early postoperative complications and long-term outcomes, such as capsular contracture and revision surgery, were recorded and described.Two hundred and eighty-eight patients were included in the study with an overall complication rate of 2.8% over 5 years. No patients had postoperative bleeding or hematoma formation. One patient had a seroma, managed with ultrasound drainage. Complications requiring re-operation included rippling (3, 1.0%), pocket revision (2, 0.7%), capsule contracture (1, 0.3%) and rupture (1, 0.3%).This study highlights the safety and potential benefits of the use of topical TXA in breast augmentation, with low bleeding and capsular contracture rates.