Could it be the Tyndall effect? Can it resolve with more time? How much longer? Could it be permanent?

Question

I had my nasofabial folds injected with fillers one whole year ago, i bruised heavily, a month later i noticed that the bruises did not completely disappear but left a bluish trace that looks like a light moustache in the area above the mouth .. it is devastating to look in the mirror, could it be the Tyndall effect? can it resolve with more time? how much longer? could it be permanent? can whitening creams help a bit in this case??

Harold J. Kaplan, MD · Answer

Hi louloushamy2012.  What you are describing sounds very much like the Tyndall effect.  it happens when a dermal filler like Restylane or Perlane is injected too superficially (near the surface of the skin).  The clear liquid gel reflects light and causes the effect.
	To get rid of it, you can inject your lip with hyaluronidase to remove the product or wait for the product to wear off.  Best to talk to your injector about options.  Good luck.

Sam Naficy, MD, FACS · Answer

It is very difficult to answer your question without seeing you in person or viewing pictures of the area of concern. You should consider posting images for better assessment. From what you are describing, it sounds like you could be experiencing a "tyndall effect" to that area. I would return to the provider for further assessment and to discuss the option of removing product and to ensure what you are seeing is in fact the dermal filler.

Jordana S. Gilman, MD · Answer

The Tyndall effect is a bluish discoloration that appears if hyaluronic acid fillers are injected too superficially into the skin. The filler is a clear gel so when light reflects through it through the skin it appears bluish.

	It is possible that what you are seeing is the Tyndall effect. You mention that you had your nasolabial lines injected and has heavy bruising, and then noticed the discoloration on your upper lip. When you bruised some of the blood may have spread downward into the lip area. Sometimes when a bruise fades there is a discoloration that remains due to the iron pigment in blood. This can look brown-gray-blue depending on your skin type.

	I recommend that you return to the doctor who injected you. Certainly consult with a dermatologist who can see and evaluate the area and recommend a treatment plan.

Martie Gidon, MD, FRCPC, FAAD · Answer

Fillers injected too superficially can cause a blue discoloration because of the reflection of light. You should return to your injector for treatment with hyaluronidase since it can take years for the blue color to fade. You can then have a filler injected more deeply if you still require volume. Whitening creams will not help you.

Steven Wallach, MD · Answer

It is very possible that the bluish hue you see is  light reflex from the filler material in your lip. Hard to say without an exam.

Could it be the Tyndall effect? Can it resolve with more time? How much longer? Could it be permanent?

Answers (7)