Blueish Tint/bruising from Restylane on Cheeks

I had my cheeks filled in with Restylane to fix hollowness. At one point, the doctor said he would use an un-crosslinked hyaluronic acid to smooth out the filler. When he used this, it seems like it burned my skin, and now I have blue-ish bruising color showing through my cheeks. I'm sure it's the Tyndall Effect because I can only see it very well in certain lights. What can be done about it?

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10 Doctor Answers | Asked by berryberry in winnipeg canada

Doctor Answers (10)
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Sure it's not bruising?

Berry, The Tyndall effect is a prolonged blue hue in the skin after injection of hyaluronic acid too superficially in the skin. This causes light particles to be scattered by the material and because blue light scatters more easily than red it gives the blue appearance. The question is, how recent was your treatment and is the blueness diffuse (evenly spread) or linear? The Tyndall effect from hyaluronic acid injection is usually linear. So, if you had the treatment recently and it is... more

Superficial injection vs acute swelling

The most likely cause is a superficial injection of Restylane producing the blueish hue. It can also be acute swelling that gives this temporary coloration. You may just want to wait it out and let the hyaluronic acid and swelling dissipate, hopefully that will solve the problem. Always make sure you know exactly what is being injected. Many of our patients have received silicone injections without being specifically told what the substance is. The trouble in those cases starts years... more

You can have it removed, but that is sad given that you paid for it!

Hyaluronic acid fillers can cause bluish discolorations of the face if they are placed too superficially in the skin. That's why it is SOOO important that you go to a good doctor for it, preferably a dermatologist or plastic surgeon who does their own injections. In my office, I am the only one who does the injections and it is my personal feeling that no one other than the physician should do it in any office. While many doctors are now getting into this in order to escape medicine as a... more

Buyer beware!!

Patients must get more vigilant with their skin care choices as more and more, we are learning about unlicensed, unqualified "PRACTITIONERS" who are using illegal substances. Please see a qualified dermatologist or plastic surgeon to get this material out as soon as possible. Experienced board certified specialists know how to remove this material before it does harm.

Skin discoloration from Restylane

Restylane is a powerful and effective dermal filler. It's time Mary comes from the fact that its results are immediate and can last for approximately 6 months. Patients can experience a small amount of redness, swelling, or skin discoloration for 1 to 2 days after the injection. The effects on the skin are determined by the depth and quality of Restylane that was injected. You should return to your dermatologist and let them know of your concern. Although it is extremely rare to... more

Bluish hue after Restylane in cheeks can be resolved

The good news is that whether it's bruising or the Tyndall effect, it can be resolved, either by waiting or using one of the following. 1. For the Tyndall effect, Hyaluronidase can be used to break down the Restylane. This enzyme will cause the Restylane to dissolve, reversing the effect of the treatment and minimizing the blue hue. 2. If the effect is from bruising (we have seen some patients who come to us with bruising that has last for months), then we would suggest pulsed dye or... more

Harold J. Kaplan, MD

4 reviews

Los Angeles Facial Plastic Surgeon

www.celibre.com

Patience is the best remedy for Tyndall effect

This does sound like Tyndall effect. Hylaronic acid fillers usually last 6-9 months. The bluish discoloration should dissipate when the filler resorbs. It is very difficult to aspirate a filler once injected. Hylaronidase is an option but results can be inconsistent. I agree, that if the deformity was corrected then the trade off may be the bluish discoloration. If this is acute then it could be just a bruise. Very rarely does the hemosiderin from the bruise cause a permanent stain.... more

What are your goals?

Of course all the answers below are all excellent and I have only a few comments" Did the Restylane achieve your goals? If the answer is yes then there are a couple of answers. The restylane may be too superficial but then your options are to remove it and suffer the condition which originally occured; I presume hollows below the eyes However, it is also likely affected by the thin quality of your skin which cannot be reversed. It is similar to saying why do you have blue veins on the... more

Otto Joseph Placik, MD

33 reviews

Chicago Plastic Surgeon

Off label treatment

Yes, it sounds like the Tyndall effect from injecting a bit superficially. Some doctors are using hyaluronidase( off-label) to break down the HA's. This may soften the efffect of the superficial HA's.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Talk to your doctor

I would ask your doctor first what he used in addition to Restylane. There is currently no FDA approved uncrosslinked products in the US, I am not sure about Canada. Uncrosslinked hyaluronic acid usually does not last in the body and goes away in several days. It might mean that the bluish effect will go away, but the smoothing effect might be gone as well. If you are still unhappy in a couple of weeks, Vitrase (hyaluronidase) injection can dissolve the remaining Restylane and probably the... more