What is the best filler for avoiding getting the tyndall effect under my eyes?

Although Juvederm UltraXC and Restylane L work well for treating the delicate under eye region, my personal preference in my Upper East Side Manhattan office is Belotero Balance, which is not associated with the development of the Tyndall effect--even when injected superficially. Volbella, which I use in Israel practice, where it is approved (it is not approved in the U.S. ) is marketed for use in the lips and for the peri-oral regions, rather than under the eyes. Likewise I would not have chosen Juvederm Ultra 3 (another product not available in the U.S., but available in Israel) for the infraorbital region.Since filler treatment results under the eyes may last far longer than the usual 8-14 months that they do in other areas, it would seem prudent to dissolve the hyaluronic acid currently present and then to retreat.

Thank you for sharing your question and I am sorry to hear of your Tyndall effect after filler placement.  Vitrase will work to dissolve both Ultra and Volbella to restore your previous appearance and improve the bluish discoloration.  It may take longer to rid yourself of the blue effect than dissolving the filler alone and a thinner filler such as Restylane or belotero can be used in the future.  Hope this helps.

Tyndall effect happen when there is a bluish colour that visible underneath the skin. The key thing is the depth and the amount of fillers used and not as much about the kind of the filler. Smaller amount under the eyes are better rather then creating full/swollen look.It is all about the doctor doing the injections.

It is more the technique and skill of the injector rather than the product. We have used Juvederm in this area with no Tyndall effect.Hyaluronidase can resolve the bluish tinge, but it will take a few days or so for it to work. Therefore, it's not "immediate".

Vitrase can be a good option to help treat the Tyndall effect. Redensity ll for under eyes works excellently. Consider an in person consultation to discuss the Tyndall effect. There are a few factors that need to be assessed when considering the Tyndall effect such as, technique and skin. Best, 

Each physician has their personal preferences for which filler they use under the eyes. I prefer Restyane and Belotero. I find that the initial swelling is more intense, but after the first two days, that's it. I have found that with Juvederm, sometimes swelling can occur on and off over a few months' time. To treat the Tyndall effect or over-filling, Vytrase is very effective. Regarding timing, dissolve the excess filler. Wait a few weeks then follow up with treatment using Restylane or Belotero.

Vitrase will absolutely help. Sometimes tyndall can last years - long after the Juvaderm is gone.  Seek an expert injector to discuss your options for fillers in this complicated area.

The vitrase should dissolve the juvederm and this will eliminate the blue discoloration.  Belotero is a good filler for this area specifically because it does not produce a tyndall effect.

Hyaluronidase will treat the tyndall effect, however it may take a few treatments.  It would be best to see another injector or have a different technique performed at your next visit to avoid this complication.  I frequently treat patients who have had this occur by using a cannula rather than a needle and avoid superficial injection, without any complications.  I find that belotero helps avoid tyndall but doesn't last long.  Nobody knows which filler gives the most tyndall as it is due to a combination of factors -- technique, water retention of the filler, skin texture and translucency ect.  Find a different expert in the field.  I wish you the best of luck, Dr. Emer.

Yes, vitrase works immediately. The hyaluronidases are a family of enzymes that degrade hyaluronic acid. Clinically it works in a matter of seconds. There is no reason to wait if you are unhappy with the results. Belotero is a much better options for peri-ocular region and if one wish to treat fine lines as it can be deposited much more superficial. Having said that one should always be careful injecting fine lines around the eye. In our experience the fine lines around the eyes are threatened much more efficiently and cost effectively with fractional co2 lasers.