A Randomized Control Trial Assessing the Effect of Topical Tranexamic Acid on Risk of Hematoma in Breast Surgery

Inclusion Criteria: * Patients undergoing bilateral breast reduction or bilateral gender-affirming mastectomy * For patients undergoing bilateral breast reduction, any skin incision pattern or pedicle is acceptable. * For patients undergoing bilateral gender-affirming mastectomy, any skin incision and mastectomy type is acceptable Exclusion Criteria: * Active thromboembolic disease or history of intrinsic risk of thrombosis or thromboembolism, including retinal vein or artery occlusion * Current use of systemic anticoagulation * Hypersensitivity to tranexamic acid * Concomitant use of combined hormonal contraceptives * Use of factor IX complex concentrates, anti-inhibitor coagulant concentrates or all-trans retinoic acid * History of acquired defective color vision * History of subarachnoid hemorrhage * Pregnancy * History of renal impairment or serum Creatinine \>1.5 milligrams per deciliter (mg/dL)