Is this Tyndall effect? What other procedures would you recommend instead? (photos)

Question

I have had about 5 syringes of Restylane under my eyes over the course of 3 years. I honestly don’t believe it is working, and now on one of my eyes I am left with this weird “ridge” of filler that has turned blue, and not even concealer helps. I am honestly wondering if I should just get it dissolved and go for a lower blepharoplasty? Fat grafting? Orbital implants? Honestly not sure what to do at this point, please help!

Eric M. Joseph, MD · Answer

Bluish discoloration of thin under eye skin after HA fillers is the Tyndall effect, and you appear to have it. You can discuss with your doctor whether dissolving the HA would decrease the ridge and the blue color. Hope this helps. Dr Joseph

Jonathan Kulbersh, MD · Answer

Hello, and thank you for providing photos along with your question. Based on your photos, you do appear to show signs of a Tyndall effect (when a patient takes on a bluish tone after a dermal filler treatment, often visible in the skin below the eyes due to the area's thin skin). And if you have a true Tyndall effect, then the best way to eliminate this is to dissolve the filler with hyaluronidase.

It is best to return to your physician for an assessment. Keep in mind that tear trough filler requires a great amount of precision and skill to perform correctly. My office typically uses a microcannula rather than a needle to administer the treatment to ensure the best possible results. Fat transfer or a lower eyelid lift are additional options for this area.

To know for sure, I highly recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon, particularly one with extensive experience with injectables. These experts are armed with a better knowledge of facial anatomy, as well as the most advanced injectable techniques that can achieve the most natural-looking results. During your consultation, your surgeon can assess your skin quality and facial profile, recommend the best approach, and ensure the best possible outcome.

Oakville Plastic Surgery &amp; Medspa · Answer

From the picture you submitted, it appears your swelling/tyndal is a result of the fillers. Before considering other procedures, you might consider a more gentle approach to dissolving. This means not dissolving all the syringes that have been injected. But rather, to use a lighter approach by settling down the filler that is closer to the surface. This achieved through the level of dilution and as well as the depth of the injection.

Leonard Grossman, MD · Answer

You do have Tyndall effect and you clearly have an appearance of having been over filled. In my humble opinion hyaluronic acid filler should NOT be placed into the tear trough or the lower eyelid where the skin is extremely thin. Any filler placed around the eye if it’s very gelatinous, becomes displaced by the orbicularis oculi muscle. For that reason I recommended all of my patients fill this area with their own fat. In my hands the results are permanent and extremely natural in appearance. You need to find a doctor in your area who is vey experienced in fat grafting procedures to the face. I hope this helps and good luck from New York City Plastic Surgery

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hi there,

Have a consultation with an ocular plastic surgeon to discuss your options.
Fat transfer may be a great option for you.  See an expert!

Best of luck!

Is this Tyndall effect? What other procedures would you recommend instead? (photos)

Answers (5)

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