Bleeding is an important consideration in breast surgeries that involve large resections of
soft tissues in the breast. Inappropriate bleeding during or after surgery, can lead to
uncomfortable fluid buildup in the breasts known as a hematoma or seroma, which may require
additional procedures or reoperation. Patients may experience a great deal of discomfort and
additional costs as a result; additional hospital time and procedures also burdens health
care spending. Tranexamic acid (TXA) is commonly used drug in many medical settings to reduce
excessive bleeding; however, no such drug is standard practice in breast surgery. The aim of
this study is to determine if TXA is superior to placebo in reducing the bleeding
complications in breast surgeries, including reduction mammaplasty, mastectomy with and
without immediate tissue expander and implant-based reconstruction, and oncoplastic breast
surgery. This study is a randomized, double-blind, placebo-controlled trial. Patients
undergoing these procedures will be randomly allocated to receive either TXA or placebo.
Patients will be placed on a drug/placebo regimen of 3 doses/day for 6 days starting on the
day of their surgery. The primary outcome is the incidence of hematoma and/or seroma
formation following breast surgery. Cost analysis of the intervention will also be performed.