4 weeks post-op Tear Trough Injections, is this bruising normal? (photo)

Question

Hello. I had filler under my eyes to reduce my bags. It's been about a month and I still have bruising. Is this normal? Also, is yhis something other than superficial bruising?

Jason Emer, MD · Answer

I recommend getting an evaluation to determine cause. This could still be bruising which can take several weeks to resolve, but it could also by Tyndall, which can be reversed with hyaluronidase. I recommend using cannulas with tear trough injections to reduce the risk of swelling and bruising. See an expert. Best, Dr. Emer

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  Depending on how significant your bruising was after the injections you may still need to allow more time to pass for the residual discoloration to resolve.  I do not think this appears to be a Tyndal effect.  See your injector for an in-person evaluation to discuss your current results.

Matthew Brace, MD · Answer

The skin around the lower eyelid bruises very easily. The skin is also very thin. Improper product choice or placement in this area can cause the product to be visible and appear as a bruise. At 4 weeks after the injection your bruising should be nearly, if not all, resolved. Treatment with a VBeam Perfecta laser can help bruising dissipate faster. Sometimes hyaluronidase is needed to dissolve some of the visible product that appears as a bruise. Check in with your injector to have it assessed and treated if necessary.

Hardik Soni, MD · Answer

Typically at one month post procedure all bruising is resolved. However, from your photo this appears to be slowly resolving bruising. This can happen if you are taking blood thinning medications, such as Ibuprofen. You can cover this up with make up until it resolves. I recommend having a follow up with treating physician to have this evaluated. Best of Luck!

Shaun Patel, MD · Answer

This looks like residual bruising and based on its color, it should resolve soon. This does not look like Tyndall given its yellow-brown color. If you have any other concerns, I suggest you follow up with your treating physician to discuss.

Kristin J. Tarbet, MD, FACS · Answer

This look like residual bruising. My expectation is that this will resolve. I would recommend following up with your provider if you have further concerns.,

Richard Wellington Swift, MD · Answer

Dear Melissa, Thank you for posting your photo with your interesting question. It is most likely the result of superficial bruising; however, it may be due to the Tyndall effect from superficial placement in patients with thin and fair skin. If this doesn't improve in the next 2 weeks, I recommend that you return to your previous injector for follow up or obtain a second opinion from a Board Certified Plastic Surgeon who is experienced with tear trough injections. Best wishes, Dr. Richard Swift

Kyle T. Yamamoto, MD · Answer

As mentioned, bruising from under eye injections should be resolved by one month.  In rare cases, however, some people can still have lingering bruising or hemosiderin staining (think of it as some iron remnants that are left behind by the previous bruise you had in that area).

The other possibility is that you are seeing some "Tyndall effect" from the filler.  This happen when light goes through the skin and reflects off filler that is placed too superficially in that area (think of a similar reason as to why the sky is blue).  The appearance can resemble a bruise.

Did you have a significant amount of bruising after your initial injection?  If so, some lingering bruising or hemosiderin staining is more likely vs. Tyndall effect.  If the appearance of your bruising in your photo has been more or less the same since you had the injection, it is more likely Tyndall.

Truly the only way to know for sure is to revisit with your injector and have him/her examine you.  Bruising or hemosiderin can be treated with laser or topical skin care products.  Tyndall effect can be treated by dissolving the filler with a hyaluronidase injection.

Best of luck!

Steven F. Weiner, MD · Answer

At one month there shouldn't be anymore bruising. This is either hemosiderin from resolving bruise or Tyndall effect. The Tyndall effect is when filler I placed too superficially and the sunlight or ambient light reflects a blue color to the area. If this is the case, it needs to be dissolved with hyaluronidase. It it's hemosiderin, creams and lasers will help.

Roni Munk, MD · Answer

from the pictures it does look like the bruising is still lasting but it is almost gone. This is uncommon but can happen. It should resolve within 1-2 more weeks. If it doesn't let your doctor know. Makeup can definitely be helpful to hide this type of bruising.

4 weeks post-op Tear Trough Injections, is this bruising normal? (photo)

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