Tyndall effect and Botox. Will my skin go back to how it was?

Question

Hello doctors, I would like to know if Tyndall effect after undereye fillers goes away naturally cuz I'm scared to have another injections of hyoluridinase and will make it worse and especially I don't trust my surgeon with another injection!! Also, I would like to know after botox goes away does the skin go back to how it was originally or will it affect the elasticity of my face? How long the Tyndall effect and botox goes away? Thank you very much

Nirmal Nathan, MD · Answer

Hi there. The Tyndall effect is a known complication of filler, especially when injected into the tear trough region where the skin is thin. It is important to go to an experienced injector who understands this phenomenon, and who can select a filler that will minimize this risk.

Botox generally lasts 3-4 months. After just one treatment the skin will likely go back to how it was originally. Botox should not effect the elasticity of the skin. After many consistent treatments of Botox, you will see the wrinkles that were treated become less noticeable, and they will oftentimes disappear.

I would recommend having an honest discussion with your surgeon. You mentioned trust issues, which is concerning because trust is the cornerstone of every physician-patient relationship. Always make sure that your surgeon is board-certified, as is taking the time to evaluate and treat you without rushing. Hyaluronidase should resolve the Tyndall effect, and will prevent you from having to wait for several months for the filler to reverse. Hope this helps.

Jason Emer, MD · Answer

The tyndall effect will last until the filler resolves or it is dissolved with hyaluronidase. When Botox results resolve in 3-4 months, the skin will go back to normal. It won't negatively impact elasticity. See an expert. Best, Dr. Emer

David Gilpin, MD · Answer

Thank you for your question.  The Tyndall effect is an uncommon side effect of a hyaluronic acid filler, which causes a blue tinted appearance to the skin.  This is caused because of the filler itself, and because of the water that it absorbs.  Most often the filler is injected too superficially, but this is not the only reason for it.  The Tyndall effect will last until the filler is either dissolved or it resorbs.  It is important to tell your injector, and any other injectors that this has happened, as a different type of filler should be used in the future to prevent this.  Once the effect of Botox has gone away, the rhytids (wrinkles) in the skin will return. However, after several treatments of Botox, I have seen softening of deep wrinkles even after the Botox effect has worn off.  I hope that this helps!-David Gilpin

Stephanie Olivier, MD, FRCSC · Answer

Thanks for you question. The Tyndall effect will go away with time, lot and lot of time depending witch product was use to do your fillers under your eye. Sometimes it takes few injections of hyaluronidase to get all the product out, specially if the product is reticulated  as ( Voluma, Volift or Volbella). Its super important to have trust in your surgeon, you should get a other assessment if you dont fell confortable with him do to it. Botox, is going away way faster ( 3-4 months). All the skin will go back to normal and your muscle will restart to have their full fonction. I hope that the answer will help you. Dont hesitate if you have any other question. Wish you all the best
Dr Stephanie Olivier MD, FRCSC

Kimberly Finder, MD · Answer

It sounds like you've had a bad filler experience that has required dissolving with hyaluronidase. If the filler is completely dissolved, which is can be, then any bluish color (Tyndall effect) will be resolved. If you don't feel comfortable with your physician, find a new physician you can have a good rapport with. Once Botox wears off, you go back to exactly the way it was before. Keep up with doing Botox; it works best as a prevention--so you don't get etched in lines and wrinkles.

Steven Wallach, MD · Answer

The Tyndall effect occurs when filler is placed too superficially. This may get better when he product dissolves or may require dissolving.

Onir Spiegel, DDS, PhD · Answer

Hi Dina,
Botox, Dysport and Xeomin only last in our system for about 3 months.  Most of us wish it last longer. The good news for you is not to worry.  It will go back to how it was.  You'll just always look three months younger.  The key is to find a doctor you feel comfortable with.  Good luck!

Peter J. Jenkin, MD, FAAD · Answer

Rest assured that none of these issues are permanent or cause permanent changes.  The Tyndall effect is a bluish colour of the skin associated with the hyaluronic fillers and is seen more with some than others.  It resolves as the filler is resorbed and will resolve in 24-48 hours with hyaluronidase.  There are no long term "penalties" for not continuing botox-the skin just goes back to what it would have been without-not worse.  Hope this helps.  Best.

Lisa Jenks, MD · Answer

I am sorry you are experiencing a discoloration after filler!  This is a well-known, although not common, side effect that can happen when fillers are injected into an area.  It is usually, although not always, because the filler has been injected too superficially.  It often does not go away until the filler does, which can be 10-12 months.  However, there are things that can make the filler go away more quickly.  An enzyme can be injected into the area which dissolves the filler - usually within 2-3 days.  There aren't many risks with injected the enzyme (hyaluronidase) except for the possibility of bruising.  Massaging the filler after it's warmed up (i.e. when in the shower) can also help it to dissolve, although not as completely or quickly as the enzyme does.
Botox will not cause your skin to stretch.  The effects of Botox are usually gone in about 3 or 4 months.

Melvin Elson, MD · Answer

The Tyndall effect should go away completely within a couple of weeks and Botox wears off in 4 months or so and then all returns to baseline. since you state you don't trust your doctor the fist thing you should do is change doctors

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