Tranexamic Acid for Postoperative Outcomes in Breast Plastic Surgery: A Systematic Review and Meta-analysis

Tranexamic acid (TXA), a synthetic antifibrinolytic agent, offers considerable promise as a potential therapy to improve postoperative outcomes for patients undergoing breast surgery. However, its specific role in plastic breast surgery remains understudied. Hence, we aimed to evaluate its efficacy in cosmetic plastic breast surgery.

An extensive literature search of electronic databases such as PubMed, Embase, and Cochrane CENTRAL was conducted from inception to October 2023. Quality assessment of the included studies was done using the Newcastle-Ottawa scale (NOS). The results of our analyses were presented as odds ratios (ORs) with 95% confidence intervals (CIs) and pooled using a random effects model. A p-value < 0.05 was considered significant in all cases.

A total of 8 studies, encompassing 2311 participants were included in our analysis. The pooled analysis demonstrates that TXA is associated with a significant improvement in hematoma formation (OR 0.37, 95% CI: 0.24-0.58; p < 0.0001). There was no significant improvement in seroma formation (OR 0.65, 95% CI: 0.33-1.27; p = 0.21), infection rate (OR 1.84, 95% CI: 0.49-6.94; p = 0.37) or partial loss of the nipple-areolar complex (OR 0.47, 95% CI: 0.12-1.82; p = 0.28).

Tranexamic acid demonstrated considerable efficacy in improving postoperative outcomes for patients undergoing cosmetic and reconstructive breast surgeries.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .