Five weeks post tear trough filler. Could this be Tyndall effect? (Photo)

Question

I had juvederm volbella injected into the tear trough region five weeks ago. Initially the results were fantastic, but now, especially in certain lights, a blue tinge seems to be apparent, only under my left eye. I was just wondering if you think this could be the Tyndall effect and if so, would the enzyme to dissolve it work? Thanks in advance.

Andrew P. Amunategui, MD · Answer

While all of the juvederm (hyaluronic acid) products can give fantastic results, they can also be associated with Tyndall effect, especially in the tear trough area (they can also increase swelling or "puffiness" in patients with pre-existing malar bags).   Having observed this from clients treated elsewhere, I will often choose other products in these areas.  Hyaluronidase can be used with varying success.  Untreated, the effect can sometimes persist for many months.

Mariusz Sapijaszko, MD, FRCPC · Answer

Tyndall effect can happen with most fillers. Based on your photos, it is difficult to say if that what is happening but, in any case, please see your dermatologist, review your situation and see if hyaluronidase can helps.I hope that helps and best regards,Dr.Sapijaszko.

Jerome Edelstein, MD · Answer

I suggest you return to your injector to talk about your concerns. It may be the Tyndall effect, however you would have to see you pre-treatment photos to determine if this is true. Hyaluronidase can help.

Thomas Trevisani, MD · Answer

Without your pre-procedure photo- difficult to comment accurately. It could be Tyndall effect-- it is best to discuss it with your injector. It can be dissolved with hyaluronidase.FYI: In the US- this product hasn't been approved by FDA yet

Mathew A. Plant, MD, FRCSC · Answer

It could be but it's tough to be sure without knowing what you looked like before. Best to follow up with your injector if you are worried.

Martin Jugenburg, MD · Answer

This could be Tyndall effect, it would be beneficial to have a before photo for comparison. Visit your injector, if you are unhappy with the results you can speak with your injector regarding hyaluronidase injections to remove the product. Otherwise, you can cover with make up.Best,

Michael A. Zadeh, MD, FACS · Answer

Hi Jade. From your pictures that does look like the Tyndall effect as you suspected. You should schedule a follow up with the person that did your injections for an in-person evaluation. Hyaluronidase can effectively dissolve any Juvederm in the area. Best of luck to you.

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question Jade3791. I understand your concern. Volbella is a
hyaluronic acid filler designed to enhance the lips. It can also be used in the tear troughs. It is difficult to make an assessment with these photographs due to poor lighting. Also it is unclear if any of the photographs is before the treatment. In any event, if fillers are placed too close to the skin it can lead to the appearance of a blue color which is called the Tyndall effect. In these cases the product can be dissolved with hyaluronidase and placed deeper in the skin. Please
consult with a doctor for specific recommendations. Good luck!

Michele S. Green, MD · Answer

I agree with Dr. Lim as it is difficult to say form the photos if this is indeed the Tyndall effect.  Volbella, Restylane, and Belotero are all excellent fillers for this under eye area.  If you feel that there is still a blue tinge then I would encourage you to have the product dissolved with Hyaluronidase.  Please consult an expert in facial fillers and the delicate under eye area for the best cosmetic results.  Best, Dr. Green

Gail Nield, MD, FRCPC · Answer

Hello, I am sorry but it is just too difficult to make any comments with respect to your photos. Please see your physician injector if you have any concerns so that she/he may examine you properly and compare pre to post treatment photos. Best of luck.

Five weeks post tear trough filler. Could this be Tyndall effect? (Photo)

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