The effect of topical tranexamic acid on post-rhinoplasty periorbital ecchymosis and eyelid edema

Background: This study aimed to examine the effectiveness of topical tranexamic acid application in overcoming periorbital ecchymosis and eyelid edema in patients who have undergone open-technique rhinoplasty. Methods: Fifty patients were included in the study and divided into two groups: those who had topical tranexamic acid applied and those who did not (controls). In the tranexamic acid group, tranexamic acid–soaked pledgets were placed under the skin flap in a way that both sides could reach the osteotomy area and left for 5 minutes. In the control group, isotonic saline–soaked pledgets were placed under the skin flap in the same manner and left for 5 minutes. Digital photographs were obtained on postoperative days 1, 3, and 7. Eyelid edema and periorbital ecchymosis were scored by two different examiners and averaged for comparison. Results: Edema that developed in the patients who had tranexamic acid applied was significantly less than in the control group on postoperative day 1. There was no difference between the two groups on postoperative day 3 or 7. Ecchymosis that developed in patients who had tranexamic acid applied was significantly less than in the control group on all days. Conclusions: Topical tranexamic acid applied to the surgical field immediately after osteotomy in rhinoplasty surgery reduces the development of postoperative periorbital ecchymosis. In addition, the topical tranexamic acid application also reduces the development of eyelid edema in the early postoperative period. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.