Tranexamic acid has gained recent popularity as a means to minimize blood loss during high volume liposuction. Tranexamic acid was first used in cardiac cases and more recently in orthopedic surgery for hip replacements to minimize unnecessary bleeding. Since high definition body contouring requires high volume liposuction, tranexamic acid has been advocated to reduce blood loss. Tranexamic acid promotes clot formation by blocking a protein lysine from binding onto plasminogen. Plasminogen is a molecule that triggers the fibrinolytic cascade that breaks down clots. When Tranexamic acid is added to the intravenous fluids it will block the activity of plasminogen thus hindering the breakdown of clots and thus promote hemostasis. The current standard dosing used in the United States includes an intravenous dose of 10mg/kg per dose which is mixed with 100ml of normal saline and administered over 10 minutes. A single dose is usually given at the beginning of the case and another at the end.
Although this dose is given to make the blood less oozy, it has not been shown to increase the risk of deep venous thrombosis. Deep venous thrombosis describes the creation of potentially detrimental clots in the legs that can travel to your heart and lungs. Since this can be a lethal complication, a clot promoting agent automatically triggers concerns about promoting a DVT. Fortunately, studies have proven definitively that tranexamic acid does not increase the risk of a DVT! Interestingly, in South America, tranexamic acid is being mixed in the tumescent solution at a dosage of 1 gram per 1000cc of lactated ringers. This modification has been done in an attempt to improve overall efficacy by localizing it at the location of the liposuction where tranexamic acid benefits to high definition body contouring can be appreciated.
Minimizing blood loss during liposuction is very important during high volume liposuction cases. As such tranexamic acid benefits to high definition body contouring are clear. The typical drop in hemoglobin of 2 to 3 g/dl following high definition liposuction cases makes the management of blood loss and fluid hydration critical. As such, tranexamic acid administration is proving helpful in decreasing overall blood loss during high definition body contouring cases. Please see this 52-year-old female who achieved her goals using tranexamic acid benefits to high definition body contouring.