Tranexamic Acid in Nasal Mohs Reconstruction

Inclusion Criteria: 1. Adults at least 18 years of age undergoing local flap reconstruction (bilobe flap, note flap dorsal nasal flap, advancement flap) of a nasal defect following Mohs micrographic surgery. Reconstructive procedures will be performed by Drs. Yang or Patel in the division of Facial Plastic Surgery in the Department of Otolaryngology, Head and Neck Surgery at Vanderbilt University Medical Center. 2. No other facial plastic procedure or sinus surgery performed simultaneously. 3. Lack of all the below exclusion criteria. Exclusion Criteria: 1. Known allergy to TXA 2. Intracranial bleeding 3. Known defective color vision 4. History of venous or arterial thromboembolism 5. History of coagulation disorder 6. Active thromboembolic disease 7. Severe renal impairment (diagnosis of chronic kidney disease) 8. History of acute myocardial infarction 9. History of stroke 10. History of seizure 11. History of liver failure 12. Preoperative lab results indicating thrombocytopenia (platelets \<150,000), increased bleeding risk (PT over 45, INR over 1.2).