Is this Tyndall Effect or just old age? (photos)

I had juvederm in tearthroughs last september and then again in January 2016, then I had some voluma in my middle cheek...I feel like my eyes look way more blue, like I've got black eyes. I can't cover it with makeup and I feel old and gross. The doctor did bruise my left cheek with the voluma, and it's been two weeks and it's still not gone..will that ever go away either? Is vitrase worth a try or will it further destroy my face.

Doctor Answers 11

Tyndall Effect or Overfilled

This could either be Tyndall effect or overfilling of the medial cheek area, or both. A good physical exam will determine the exact cause. I would wait a couple more weeks to see how things settle before you decide if anything should be dissolved. Vitrase used conservatively should not cause any long-term problems.


Columbus Facial Plastic Surgeon
5.0 out of 5 stars 41 reviews

Tyndall effect in tear troughs

Thanks for the question.  Your skin may be inherently discolored in that area.  This is not that uncommon but makeup can cover this up over time.  It almost looks too uniform to be the Tyndall effect but hard to tell from the pics.  It may also be some increased vascularity from the injections that may fade over time.  Just be patient for now and follow up with your doctor to see if other options exist.  In general, Juvederm in the tear troughs works VERY well.

Taha Shipchandler, MD
Indianapolis Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Is this Tyndall Effect or just old age

Hi there, you are not old looking at all, and this does appear to be a Tyndall effect underneath your eyes.  I would recommend Vitrase to dissolved some of the Juverderm. Make sure that you are wearing sun screen over this area everyday and do not rub your eyes at all. Although I love Juvederm, I would use Restylane under your eyes in the future as it lays better in most people. Good luck Dr. Downie.

Jeanine B. Downie, MD
Montclair Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Overfilled tear trough

Hi. Sorry you are not happy with your result. From the photos provided, it looks like your tear trough may be overfilled. Juvederm is usually considered "too thick" for the tear trough and can cause lumps or shadowing- similar to what you are experiencing. I prefer belotero or restylane silk for this area. One option for you may be to dissolve your current filler with hyaluronidase and then have it filled again with a different product. Hope this helps. Best regards, Ira Vidor, M.D.

Ira Vidor, MD
Newport Beach Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

Not old age!

Your photos suggest a Tyndall effect secondary to injection in the tear trough area. Options include hyaluronidase injection to reverse, or waiting 4-6 months to see if this appearance gradually settles. It depends on the frustration level. The bruising should resolve over the next couple of weeks. Best wishes for improvement.

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Swollen eyelids

It is difficult to tell from a one photograph. But it appears to be where the filler was injected too superficially and Juvederm is a poor choice of fillers for this area. It is hydrophilic which means it attracts water which caused the swelling. Vitrase/hyaluronidase can be injected which would dissolve it.

Byron A. Long, MD
Marietta Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

IF you are unhappy with fillers you can reverse with hyaluronidase enzyme.  I find that lasers, fillers, and microneedling/PRP in combination do best.  Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Tyndall Effect Post Injection

Thank you for your question.It is difficult from your photo to tell whether this is a true Tyndall Effect or hyperpigmentation in combination with increased vascularity.Communicate with the surgeon who injected you. They want you to have a great result too. Vitrase is very safe to use.Best wishes.

Greg Chernoff, MD
Indianapolis Facial Plastic Surgeon
4.8 out of 5 stars 27 reviews

Tyndall effect from Juvederm

Yes, this is tyndall effect and I see the typical edema associated with Juvederm in this area. This is the wrong filler for this area in my opinion. I prefer Restylane much more for this. It should be dissolved with hyaluronidase. Please see the link about Juvederm in this area and why it's not the right filler.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Tyndall vs. Bruising

Thank you for your question. The short answer is, it could be either Tyndall Effect or Bruising. Chances are, however, that it's Tyndall. You do have some shadowing and a somewhat bluish discoloration under your eyes - especially on your left side, where your bruise was / is. You have a couple of options. 1) Wait another 2 weeks to see if this resolves; chances are you still slightly bruised or swollen from your prior injections 2) Have a light laser (IPL) performed on the "bruised" areas to see if that improves anything. Typically this can help to break up the hemosiderin deposits more quickly and lead to a faster resolution of the bruising 3) Try some light treatment with hyaluronidase - which will dissolve the filler. Hyaluronidase focuses on the filler specifically, and does not interact with your normal tissues. Typically, I won't use Juvederm in the tear trough areas (unless there is a lot of depth that needs to be filled out) because of the potential for Tyndall (at least in my hands). I much prefer restylane, restylane silk or belotero. Best of luck! 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.