Systemic Administration of Tranexamic Acid Improves Postoperative Outcome in Abdominoplasty

<b>Background/Objectives</b>: In plastic surgery, the administration of tranexamic acid (TXA) has gained increasing support by current literature, highlighting its relevance in clinical practice. This study evaluates the perioperative impact of prophylactic intravenous TXA administration in abdominoplasty, focusing on surgical outcome, drainage pattern, complications, and laboratory parameters (hematocrit/hemoglobin). <b>Methods</b>: This retrospective, single-center cohort study analyzed 58 abdominoplasties, which were divided into two groups: patients treated perioperatively with tranexamic acid for 48 h (TXA group; <i>n</i> = 24) and without TXA (no-TXA group; <i>n</i> = 34). <b>Results</b>: Patients in the TXA group had a significantly shorter length of hospital stay (<i>p</i> = 0.008) and a lower postoperative daily drainage volume on postoperative days: 3 (<i>p</i> = 0.047), 4 (<i>p</i> = 0.011), 7 (<i>p</i> = 0.014), 8 (<i>p</i> = 0.024), and 9 (<i>p</i> = 0.042). The overall complication rate was also significantly reduced with TXA (25.0% vs. 52.9% in the no-TXA group; <i>p</i> = 0.033). Postoperative declines in hematocrit and hemoglobin were less pronounced in the TXA group (<i>p</i> = 0.353 and <i>p</i> = 0.255, respectively). Furthermore, the intravenous administration of TXA was well tolerated, and no associated thromboembolic events were observed. <b>Conclusions</b>: Intravenous TXA appears to reduce complications, drainage volumes, and hospital stay in abdominoplasty patients, while being safe and well tolerated. Although further studies are needed to define optimal dosing, administration protocols, and long-term safety, these findings support the potential benefits of TXA for both patients and healthcare systems, thereby enabling a standardized approach to body contouring surgery.