Juvederm: Q&A

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Solution to Tyndall Effect, Suborbital 'Pillows' Post-Juvederm Injections?

8 months post Juvederm Ultra injected into tear troughs, I am still getting questions, even from strangers, about the blue puffy horizontal pillows under both my eyes. The volume has lessened some but the blue persists. I think I look like I have football paint on when under direct overhead lights. Is it too late for hyaluronidase? Am I at risk of permanent blue disfiguration? I'd prefer to email photo directly not post it. thanks in advance!

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10 Doctor Answers | Asked by workinprogress in Colorado

Doctor Answers (10)
Community Comments (2)

Hyaluronidase

Even months later you should be able to have the blue-tint removed through the use of hyaluronoidase, an enzyme that destroys the hyaluronic acid (remember ase at the end of a chemical signifies that it is an enzyme. Two caveats, however. One is you should be tested with this material to ensure you are not allergic. Two, hyaluronidase should be titrated. Maybe see your physician once a week until the desired goal has been met. more

Arnold R. Oppenheim, MD

6 reviews

Virginia Beach Dermatologist

Blue discoloration after filler

You are describing the tyndall effect when filler is placed a bit superficially and the light reflects off the product. This can be dissolved.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Blue Bags Under Eyes after Juvederm?

Hi Workinprogress. What you are describing sounds like a common side effect of hyaluronic acid fillers when injected too superficially into the tear trough under eye area. The blue appearance has to do with the effect of light reflecting off these bumps in combination with the product being injected too near the surface of the skin. Because we see our tear trough injection procedures last up to 12 months with Restylane, we would suggest that hyaluronidase may still help... more

Harold J. Kaplan, MD

4 reviews

Los Angeles Facial Plastic Surgeon

www.celibre.com

The Tyndall effect after Juvederm can be injected away with hyaluronidase

The blue disfigurement called the Tyndall effect after Juvederm can be injected away with hyaluronidase and it shouldn’t cause any permanent disfigurement.

How to correct excessive fillers under the eyes

If you have excess filler under the eyes, it can be improved with Hyaluronidase. This is an enzymes that dissolves the excess filler. It is not too late to do that and might just do the trick. If you have dark pigmentation as result of too much bleeding, additional treatments may be necessary. Good Luck, Dr. Sajjadian

Hyaluronic Acid fillers such as Restylane and Juvederm can be dissolved

One of the advantages of using a hyaluronic acid filler like Juvederm and Restylane is that if the results are not ideal the filler can be dissolved. An enzyme called Hyaluronidase is injected into the areas where the filler was used. Not all the filler goes always goes away with one treatment, though since filler might have been put at multiple levels. I also don't like treating with the idea that something can be dissolved but its a good backup. The best solution is to avoid it in... more

Hyaluronidase may take the blue out of your eyelids, even this late

You may get a good response to hyaluronidase if the Tyndall effect is at cause of your bluish tint to your eyelids after Juvederm Ultra.

Blue fullness following filler

In many instances this occurs from injecting the hyaluronic in a superficial plane or beneath extremely thin skin. The hyaluronic can be removed using off label hyaluronidase.

Otto Joseph Placik, MD

33 reviews

Chicago Plastic Surgeon

Tyndall effect

If there is excess Juvederm or if the Juvederm is too superficial, then you can have the Tyndall effect. It is not too late to use hyaluronidase, even after a year from injection. Dr T.

Juvederm

Ask your DOCTOR to disolve the Juvederm. The Hyalurinidase need to be injected in the same plane to disolve it. May need more than one injection. Most of the time the tyndal effect will resolve.

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Comments (2)

workinprogress 21 Oct 2012

I no longer live in the same city as the original doc, unfortunately. The blue is mostly gone now at appx 1.5 yrs out, but the pillows, with their awful shadows in most lighting, remain. An ER doc who opened an aesthetics salon near me suggested it might be malar edema, which would be permanent and not fixable. I hadn't heard of malar edema and I'm wondering if anyone here might have a comment on what that is and if it is indeed now a permanent disfiguration. thanks!

siobhane 3 Oct 2012

I had juvederm injected under my eyes two months ago by a respected plastic surgeon in the greater DC area. I was left very bruised and swollen for a number of weeks,but was assured the swelling and bruising would abate after a few weeks. I am now nearly two and a half months post procedure and my under eye area is lumpy and blue. I had hyaluronidase injected incrementally under both eyes but these left indentations and both the surgeon and a specialist dermatologist I went to for a second opinion agreed that it might be safer to let the product dissolve naturally as the acid might damage the tissue. I am very self concious and have heard that the product can take up to 18 months to dissolve. I will also be left with the permanent divits caused by the acid and damage to the tissue.

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