Inclusion Criteria:  Are 18 years or older; Are undergoing bilateral breast reduction at either Hamilton Health Sciences or St. Joseph's Hospital Hamilton.  Exclusion Criteria:  Taking therapeutic anticoagulation; Taking antiplatelet drugs; Pregnant or breast feeding; Allergic to TXA; Cannot provide informed consent; Have a documented coagulopathy or bleeding disorder, acquired disturbances of colour vision, subarachnoid hemorrhage, hematuria, irregular menstrual bleeding, or seizure disorder.