Blue lines after Juvederm filler around my laugh lines. Any suggestions? (photos)

Question

It has been three weeks since I had juviderm filler on my laugh lines. I have bleu/grey lines on my right side of my mouth. Will it go away?it is not a bruise.

Thomas Fiala, MD, FACS, FRCSC · Answer

Hi.  Some fillers can cause a blue discoloration if injected very superficially.  This is known as the Tyndall effect.  Best to have it dissolved with hyaluronidase, and try a different filler in that area.All the best,

J. Jason Wendel, MD, FACS · Answer

Thank you for your question.I would suggest contacting the provider who performed your injections for a follow up appointment to review your concerns. The filler may have been injected to superficial which could cause a blue discoloration of the skin. To be sure what is best for you, see two or more board-certified providers in your area for a
complete evaluation to make sure you are a good candidate and that it is safe for
you to have treatment.

I hope this helps.

Brian S. Biesman, MD · Answer

Based on your description and the photograph it appears as if the solution to this problem may be to dissolve the product with hyaluronidase.  It does not look like a serious problem but will take a long time to resolve by itself.I would discuss this with the person who performed your injections to discuss treatment options.

Christopher Khorsandi, MD · Answer

This may be due to the Tyndall effect that causes light to scatter and appear blue.  The filler you had placed is a clear gel, however when light passes through it it can seem blue.  When fillers are placed too superficially this can occur.  It will go away as the filler dissolves over time, which can be sped up with regular massage.  lt can also be corrected with hyaluronidase.  Consult with a board certified plastic surgeon who can help you with this in your area.

Jason Emer, MD · Answer

I suggest seeing a filler expert for reversal of your filler, this can be easily treated with an enzyme injection.  Best, Dr. Emer.

Martin Jugenburg, MD · Answer

Thank you for your question. The blue lines around your mouth could be the Tyndall Effect. The Tyndall Effect is when you can visualize the filler through the skin. This will dissipate over the next few months as the filler wears away. Another option is to contact your injector and discuss a hyaluronidase injection to dissolve the product. All the best,

Nelson Lee Novick, MD · Answer

What you are describing is known as The Tyndall Effect, which results from the way light is scattered through the skin when a hyaluronic acid filler, such as Juvederm, is injected too superficially within the skin. Fortunately, the material causing the problem can be quickly dissolved with a natural enzyme known as hyaluronidase. Alternatively, you can wait until your own natural hyaluronidase breaks down the material, which generally takes up to a year. However you decide to proceed, I would suggest that next time around you seek the services of a board certified core aesthetic physician with extensive experience and expertise in injecting fillers and volumizers. And be sure to ask to see his/her before and after photos.

Stephen Weber MD, FACS · Answer

This is most likely the well known Tyndall effect. This results from superficial placement of certain fillers. It is seen most often in the undereye area. It can be corrected with hyaluronidase. It is important for hyaluronidase treatment to be very conservative as you do not want to remove all of the filler, just the most superficial product. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Steven F. Weiner, MD · Answer

This is the way the filler reflects light if it is injected too superficially.  Hyaluronidase will dissolve the filler and resolve this problem.  Otherwise you could wait til the filler is naturally absorbed.

F. Victor Rueckl, MD (in memoriam) · Answer

What you are describing is the Tyndall effect. Which occurs when fillers like Juvederm are placed too superficially and light reflects off of it. It will go away as the filler goes away, or you can have it removed with hyaluronidase. "This answer has been solicited without seeing this patient and cannot 
be held as true medical advice, but only opinion. Seek in-person 
treatment with a trained medical professional for appropriate care."

Blue lines after Juvederm filler around my laugh lines. Any suggestions? (photos)

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