Tranexamic Acid in Rhinoplasty: Perioperative Bleeding, Edema and Ecchymosis

This study investigates whether tranexamic acid (TXA) — a drug commonly used to reduce bleeding during surgery — can reduce bruising, swelling, and bleeding during and after rhinoplasty (nose reshaping surgery). Rhinoplasty, especially when it involves repositioning the nasal bones (osteotomies), can cause significant bruising and swelling around the eyes and face during recovery. TXA works by preventing the breakdown of blood clots, which may reduce these effects. Adults aged 18 and older undergoing primary open rhinoplasty with osteotomies at Vanderbilt University Medical Center are eligible. The study is limited to procedures performed by specific surgeons, and participants cannot be having simultaneous other facial or sinus procedures. Patients are excluded if they have a known allergy to TXA, a history of blood clots, kidney disease, heart rhythm problems, a history of stroke or seizure, uncontrolled diabetes, abnormal clotting labs, active blood-thinning medications, or intracranial bleeding. Participants receive either TXA or a placebo during surgery, with bruising, swelling, and blood loss measured at follow-up visits. This research matters to the millions of patients who undergo rhinoplasty each year — reducing post-operative bruising and swelling not only improves comfort and cosmetic recovery but could also reduce the risk of surgical complications.