Blue Tint After Juvederm a Year Later? (photo)

Thanks for the question and photos. There appears to be an excess of Juvederm in your under eye hollows, also called the tear troughs. I would recommend having the product dissolved with Vitrase (hyaluronidase) and replaced with Restylane. Restylane is a thinner product than Juvederm and the molecules are less cross-linked, which makes it less likely to be visible as a bluish hue (Tyndall Effect) under the thin skin under the eyes. Elsewhere in the face, I inject Restylane and Juvederm pretty much interchangeably, but in the tear troughs, Restylane is my filler of choice. 

Correction of this area requires a detailed understanding of the anatomy and great technical skill, so be sure to have the treatment done by an experienced injector. 

Best regards,

Dr. Mehta

   Juvederm in the tear troughs may not be the best choice.  An enzyme can be used to degrade the Juvederm.  Give this a few weeks before switching to Restylane if necessary.

Dear Ranny,

Thanks for sharing your story. As you have read the blue tint is called the Tyndall Effect. I agree with many of the answers posted- you would benefit from a treatment with hyaluronidase to dissolve the Juvederm. I also think that Restylane is a good choice for the tear troughs. That being said, even with Restylane success with tear trough treatment is technique dependent. There are multiple layers of tissue even in that thin, delicate area. One option is to place the filler just over the bone to achieve a natural contour and minimize the chance of pigmentation issues or superficial irregularities. 

 

Thanks for posting your concern. The bluish color you may see under the eyes is called the Tyndall effect.  This is the result of light scattering by the filler material (hyaluronic acid gel, or "HA") when it is very close to the skin surface.  The immediate way of treating this is with a small injection of an enzyme that dissolves the HA -- hyaluronidase, marketed as Vitrase or Wydase. In the future, the choice of fillers for specific areas of the face is really important. Different filler materials have different thicknesses and other properties.  For the tear-trough region (where you have the bluish discoloration), I recommend Restalyne. It is thinner and less likely to cause this issue.  A knowledgeable plastic surgery or dermatology expert can help you with filler choice.

The blue tint is what we call the Tyndall effect.  It occurs when the Juvederm is placed too superficially or in an area with very thin skin such as tear troughs. This can take years to go away on it's own.  I would see a skilled provider and have it dissolved with a small amount of Hyaluronidase that will break it down and remove the blue tint. You will be much happier. In the future you may want to try   Restylane or Belotero for that area. I have found it to be a better choice! 

The pictures you provided are quite helpful and I agree with your assessment and the timeline is such that at this point it is unlikely that it will resolve and hyalurinodase injections will help resolve the problem, following whcih you should seek treatment with a different volumizing product, like Restylane.

Filler in lower lids especially if injected superficially can last a long time. Hyaluronidase can be used to dissolve it.

You've been over-filled!  And you have the Tyndall effect as well, giving you the bluish tint.  Get some hyaluronidase (wydase) injected and this we be corrected immediately.  Good luck!

If you are unhappy with your results - and I think I agree with your assessment that there are some blue lumps although online photos are difficult to fairly evaluate - you can simply have some hyaluronidase injected and the unwanted product will dissolve nicely. My preference is Restylane under the eyes - I find Juvederm gets to "puffy" or full. Good luck - I think you will do great with the hyaluronidase injection!

Fillers done under the eyes in general can last longer than when they are done in other areas, because this area simply moves less. While this is good news for those that love their fillers, it's not great news for those like you that don't. The easiest way to resolve the Tyndall Effect, which as the other doctors have stated on here is what you have going on, is with a small amount of hyaluronidase, which will dissolve the superficial Juvederm and take away the blue tint.