This is a multisite, randomized controlled clinical trial evaluating the effect of local tranexamic acid on post-operative ecchymosis in eyelid surgery. Patients will act as their own controls with one eyelid receiving a control injection of standard local anesthetic whereas the other eyelid will be randomized to receive a mixture of local anesthetic and tranexamic acid. Post-operative ecchymosis will be graded by a masked reviewer using a validated scale.