I Had Injection of Restylane in Tear Trough but Could It Have "Fallen" into Area Below Due to Gravity? (photo)

Question

Upper-cheek area below lower eyelid and next to nose looks discolored, seems to have a slight vertical ridge and appears a bit swollen, and eye socket still looks somewhat hollow. I have tried to be gentle with the area. Is this normal bruising, or can the injected material somehow slip down due to gravity? I had it done 10 days ago by an oculoplastic surgeon.

Kenneth Hughes, MD · Answer

Restylane in tear trough, if the appearance is too full after swelling has resolved, can be reduce in volume with hyaluronidase.

Sam Naficy, MD, FACS · Answer

Restylane and all dermal fillers cause swelling to some extent, and you'd be best advised to follow up with your provider for further assessment and/or massaging of product.

Jonathan Kulbersh, MD · Answer

Sorry to hear about the side effects you experienced. It is possible for bruising to take place in the area around your injections, and it appears this is the cause of your issue. But there is no way the filler will slip due to gravity, as the it will not migrate from the injection site.

	In general, the typical side effects of Restylane may include:
	
	1) Minor bruising and swelling
	2) Infection
	3) Hematoma
	4) Redness
	5) Irregularities due to poor technique

	After 10 days, it is not abnormal for bruising to be present. It can take a few weeks to months to completely resolve. I would recommend speaking with your physician who performed the injections regarding any concerns you have. I hope this helps, and best of luck.

Kenneth D. Steinsapir, MD · Answer

Tyndall is a very specific effect where the HA is placed so superficial the area appears blue in color.  The photo you have provide shows a generalized overfill that partially may be due to dependent welling or gravitational effects if you will.  I do agree with Dr. Prendiville that the solution is carefully administered hyaluronidase to shape your treatment.  The goal is to shape the treatment effect rather than remove all the volume.  Unfortunately this also requires judgement and artistry and your injector may not be up to the task.

Stephen Prendiville, MD · Answer

The photo most definitely shows a very common complication of Restylane injection in the tear trough known as the Tyndall effect.  Because Restylane is a clear gel, it can appear blue when too superficial.  Although hyaluronic acid fillers are heavily used in this area around the country, this complication is much more frequent than many who promote it would admit.  If you see my other posts on this topic, you will see that HA fillers in the tear trough are a weak answer for a difficult problem. The good news is that hyaluronic acid fillers can be dissolved with hyaluronidase.

I Had Injection of Restylane in Tear Trough but Could It Have "Fallen" into Area Below Due to Gravity? (photo)

Answers (10)

Answer: This is not Tyndall.

Answer: This is not Tyndall.

Answer: There is Definitely Tyndall Effect

Answer: There is Definitely Tyndall Effect

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I Had Injection of Restylane in Tear Trough but Could It Have "Fallen" into Area Below Due to Gravity? (photo)

Answers (10)

Answer: This is not Tyndall.

Answer: This is not Tyndall.

Answer: There is Definitely Tyndall Effect

Answer: There is Definitely Tyndall Effect

Browse related questions

Recommended reading

Everything you need to know about Restylane

Our mission is to create a world where every investment in modern beauty is Worth It.