Back to 2025 Resident Posters
Use Of Topical TXA In Gender Affirming Mastectomy Leads To Increased Rates Of Postoperative Seroma
Hanaa Shihadeh, MD
1,
Ishan Patel, BS2, Mason Horne, DPT
2, Kavya Kotha, BS
2, Dzifa Kpodzo, MD
1.
1Albany Medical Center, Albany, NY, USA, 2Albany Medical College, Albany, NY, USA.
PURPOSE: Tranexamic acid (TXA) has increased use in plastic surgery due to its established safety profile and effectiveness in reducing perioperative blood loss. Recent evidence suggests additional benefits, such as decreased seroma formation. A prior study demonstrated that intravenous TXA can reduce seroma formation in patients undergoing gender-affirming mastectomy (GAM); however, alternative methods of TXA administration have not been widely explored. This study evaluates the effect of topical TXA on postoperative outcomes in patients receiving GAM.
METHODS: A single-center retrospective review analyzed consecutive patients receiving GAM from September 2022 to October 2024. Patients were categorized based on whether they received TXA infused in tumescent solution or not. The senior author (DSK) began using TXA infused in tumescent solution consistently starting in March 2023. Demographic characteristics, operative details, and postoperative outcomes were compared between groups.
RESULTS: A total of 77 patients were included, with 154 breasts analyzed; 122 (79.2%) received TXA tumescent. Patients receiving TXA had higher rates of seroma (21.3% vs. 9.4%; p=0.054). After controlling for confounding variables (BMI and smoking status), TXA remained a significant predictor of seroma (odds ratio 0.235; p=0.045). No significant differences were found for other complications.
CONCLUSION: Topical TXA infused in tumescent solution and infiltrated into breast tissue prior to GAM may increase seroma formation. Previous evidence has demonstrated that intravenous TXA decreases seroma and hematoma formation in this population. Further studies are needed to assess the effect of tumescent solution alone to determine if topical TXA contributes to this risk.
Back to 2025 Resident Posters
