The Role of Tranexamic Acid in Plastic Surgery: Review and Technical Considerations

Plast Reconstr Surg. 2018 Feb;141(2):507-515. doi: 10.1097/PRS.0000000000003926.


Minimizing blood loss during surgery is critical, and many modalities have been used to decrease unwanted surgical bleeding. Among many methods, use of pharmacologic agents such as antifibrinolytic drugs has been shown to significantly reduce blood loss and the rates of postoperative blood transfusion in many articles. Tranexamic acid is an antifibrinolytic agent that has been widely used in other surgical specialties, especially in cardiac, orthopedic, and trauma surgery. Despite its known benefits, the use of tranexamic acid in plastic surgery is extremely limited, primarily because most plastic surgery procedures do not involve the extent of blood loss that can lead to anemia and the need for blood transfusion, as is common in major orthopedic and cardiac surgery procedures. Nevertheless, there are significant benefits to be gained from the use of antifibrinolytic drugs in the full range of plastic surgery. In this article, the authors introduce the benefits, dosages, and technical considerations of using tranexamic acid in plastic surgery procedures.

Publication types

  • Review

MeSH terms

  • Anemia / etiology
  • Anemia / prevention & control
  • Antifibrinolytic Agents / therapeutic use*
  • Blood Loss, Surgical / prevention & control*
  • Blood Transfusion
  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / methods
  • Humans
  • Orthognathic Surgical Procedures / adverse effects
  • Orthognathic Surgical Procedures / methods
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / methods
  • Plastic Surgery Procedures / adverse effects*
  • Plastic Surgery Procedures / methods
  • Tranexamic Acid / therapeutic use*


  • Antifibrinolytic Agents
  • Tranexamic Acid