Rebound bleeding as a result of loss of epinephrine effect is a common problem encountered during facelift surgery.

Tranexamic acid (TXA) is an anti-fibrinolytic agent whose safety and efficacy in reducing bleeding are well documented.

We have found that local infiltration of TXA combined with a lidocaine with epinephrine solution during facelift surgery has been effective in decreasing rebound bleeding and the time required to gain hemostasis.

The authors sought to share their local infiltration protocol of TXA combined with epinephrine solution in facelift.

Patients who underwent facelift received subcutaneous injection of TXA-lidocaine 0.5% solution following the authors’ protocol.

After completing both sides of the facelift and the submental platysmaplasty, the first and second sides were sequentially closed.

The time to gain hemostasis on each side prior to closure was prospectively measured.