Juvederm Tyndall Still After 8 Months: Dr Warns Against Hyaluronidase or Extraction, So What to Do?

Juvederm 8 mths ago to correct small scar below cheek. In 2 different consults since, has been explained that juvederm was injected too superficially. Now have 1 and 1/2 centim. grey spot below cheek, creating hollow ugly grim reaper look! Visited 2 drs since: they won't do hyaluronidase as say may make area cave in. They've never heard of the extraction method-- how to find someone to do that? Possible it won't resolve with time? Otherwise fit, 55 yrs old. I live in Italy. Thank you!

Doctor Answers 7

Juvederm Tyndall Still After 8 Months: Dr Warns Against Hyaluronidase or Extraction, So What to Do?

      Hyaluronidase makes the most sense to dissolve superficially placed filler, and the area should not be any more depressed than prior to filler injection.  Kenneth Hughes, MD Los Angeles, CA

Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Juvederm Tyndall effect

Any hyaluronic acid filler can cause a Tyndall (blue hue) effect if the patient has thin skin in the area treated, or if the filler is injected superficially. Both extraction and hyaluronidase are reasonable options to improve this - see your dermatologist to have these performed. If the person injecting you with Juvederm has no experience with these things or is uncomfortable using them, then they are not the person to be treating you in the first place. Trust your health and beauty to a skin expert, such as a dermatologist. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon
4.9 out of 5 stars 49 reviews


Hyaluronidase works fabulously for dissolving hyaluronic acid filler. If left alone, the Juvederm can last for years (when injected too superficially . If it bothers you, I wouldn't hesitate or worry about "hollows." It will not look worse than it did prior to injecting the Juvederm. Extraction can also work well, but usually works best a few days after injection.

Ramona Behshad, MD
Saint Louis Dermatologic Surgeon
5.0 out of 5 stars 6 reviews

Hyaluronidase is OK!

Hyaluronidase is a very good option for you.  The area shouldn't "cave in" any more than it was to begin with.  Hyaluronidase only works to dissolve the hyaluronic acid, Juvederm, that you had.  It won't cause any other issues.  If it is done conservatively, you may still have enough left that you have a nice result. If it is all dissolved, then you will be back from where you started!    So you can live with it or dissolve it, it's up to you!


Good luck

Dr. Mohadjer

Jasmine Mohadjer, MD
Tampa Oculoplastic Surgeon
5.0 out of 5 stars 2 reviews

No Extraction

Dear patient, I would advise against extraction of the filler using any invasive method. Even the finest needles can cause scarring and irregularities. I have used Hyaluronidase under the yes with good results. Please find an experienced Dermatologist in your area. The Hyaluronidase needs to be ordered for you in advance.

A. David Rahimi, MD
Los Angeles Dermatologist
4.7 out of 5 stars 49 reviews


Please post a picture so that we can better advise you.  It should resolve by 9-12 months post injection.  If not, surgical revision may be beneficial.  Make sure you see a board certified plastic surgeon in your area.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

How to get rid of Juvederm

There isn't an extraction method for removing Juvederm. That would be a surgical excision and it's only recommended when people have a type of filler (like Radiesse) that can't be removed with hyaluronidase and its blocking an artery. You don't need a surgical procedure to remove Juvederm, period. You can have hyaluronidase, or you can wait it out. Those would be your options. Juvederm can last for up to about a year.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

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.