Do under-eye fillers cause blueish discoloration?

Question

I'm getting fed up with my tear trough lines and it's been putting a dent in my confidence. When I asked my derm about fillers, he said that he wouldn't recommend it because it causes blueish discoloration. I know lots of girls get under-eye fillers and I've never seen any blue discoloration in the before and after photos. So I don't suppose it would hurt to ask about it.

Lorrie Klein, MD · Answer

I treat under eye circles/bags with fillers on multiple patients every day in my office in Orange County, CA and it is a fantastic treatment for this area BUT if your physician is telling you not to do it, it is probably because he or she does not feel comfortable treating this area and/or they have not done it correctly or with the correct fillers.  Prolonged swelling and blue discoloration indicates that the wrong filler was used or it was not injected deep enough.Even physicians who do a lot of injectables are not always experienced or comfortable treating this area.  Make sure you find someone who does a lot of treatments in this delicate area.  Remember, not every plastic surgeon or dermatologist does a lot of fillers, so even though they are the safest specialists to go to for facial cosmetic treatments, they need to specialize in injectables and spend a lot of time doing it (not just dabble in it) to be excellent at it.

Kian Karimi, MD, FACS · Answer

Thank you for your question! The blue discoloration, clinically known as a Tyndall effect, occurs when filler is placed too superficially. An experienced injector should be able to correct your tear troughs without this complication; however, it is difficult to determine without an in-person consultation or photos. When tear troughs are well injected it yields a more youthful and well rested appearance. I recommend setting up a consultation with an experienced aesthetic provider to determine the best service to achieve your desired aesthetic outcome. 
Best of luck,
Dr. Kian

Jason Emer, MD · Answer

fillers should NOT cause a discoloration and if they do, it was done poorly or your skin didnt take well to the filler.
There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will be the best long term.  However, non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels and stem cells can all help give some improvement. I suggest. You get a formal consultation to see what is best for you and your goals.  Best, Dr. Emer.

Mark Berkowitz, MD · Answer

Muzry Thank you for your question.  The Tyndall Effect comes about with Hyaluronic (HA) fillers (juvederm, Restylane, etc) when placed too superficial.  These fillers can show a bluish hue through the thin lower eyelid skin.  Placement and choice of filler can help to decrease the chances of this occurrence.   If using HA fillers my  preference is Belotero or Volbella.  Most important is to choose a cosmetic surgeon who has a known history of pleasing clients with injections of this delicate area.  All the best #DRB

Skin by Lovely - Portland · Answer

Tear tough dermal filler treatments, when performed correctly, can create a beautiful, refreshed appearance. Blueish discoloration after a dermal filler treatment, also known as the tyndall effect, can happen when dermal filler is injected too superficially in the skin. It is correctable by an experienced aesthetic provider. Tear troughs are a sensitive area to treat, and it’s important to give yourself the appropriate amount of time to heal (around two weeks). If you have any concerns or questions after healing, an experienced injector can make adjustments as needed to ensure you’re happy with your results. Best of luck on your aesthetic journey!

Monika Soni, MD · Answer

The blue discoloration, called the Tyndall effect, is caused by injecting the hyaluronic filler (Juvederm or Restylane) just under the skin instead of deep to the muscle. This is a very, very rare problem when the material is placed by an experienced injector; most have never seen it in their patients.

Shaun Patel, MD · Answer

Hyaluronic acid based fillers like Restylane are commonly used to treatment undereye volume loss and hollows. If the wrong filler is used or the filler is placed incorrectly too close to the surface of the skin, then bluish discoloration (Tyndall Effect) can occur. This can be avoided in most cased by placing the filler relatively deep in the skin.

Leonard Grossman, MD · Answer

The blue discoloration is called the Tyndall effect and it does happen to a lot of people especially when the fillers are placed superficially where the skin is very, very thin which it is in the majority of individuals. My preferred method is to use the patient's own fat as it will provide natural and almost permanent results. Good luck from New York City

Deborah Kessler Hudak, MD, MHA · Answer

Any hyaluronic acid filler (Juvederm, Restylane, Belotero) placed under the thin skin of the lower lids can cause a bluish discoloration called the Tyndall effect.  (The thinnest skin of the body is found in the eyelids!)
More importantly, there is a risk of BLINDNESS when hyaluronic acid fillers are injected in the area of the inner 1/3 of the lower lids.  As an Oculoplastics Surgeon, specialized in eyelid surgeries, I can say this without reservation.  
It is better to use a NON-hyaluronic acid filler or volumizer if this inner 1/3 of the lower lid is desired to be treated for hollowing.  Sculptra is a particularly excellent choice for this.

Steven F. Weiner, MD · Answer

The blue tint under the eyes is called a Tyndall effect and is related to superficial placement of HA filler in the tear trough. This is not commonly seen in my practice. Filler in this area needs to be placed beneath the muscle so this doesn't occur. If you doctor said this, then he probably is not comfortable doing this and I would find another provider for it. This area is only for the experienced injector because there are additional risks including blindness and vascular occlusion. Also bruising can occur leaving a black eye for a couple weeks.

Do under-eye fillers cause blueish discoloration?

Answers (14)

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