How to Avoid the Tyndall Effect?

Question

Just want to be sure I understand, can the Tyndall effect be avoided by injecting under the muscle, in the tear trough area?
I had this done four days ago and I see a very slight bruising, but I think it is because the restylane is still concentrated in a raised area that is shadowing in a manner resembling slight bruising.  I hope that when the swelling goes all the way down, the bruising look will go away too.

Mark Berkowitz, MD · Answer

The tyndall effect comes about when Hyaluronic Acids (Restylane, Juvederm, Elevess) are placed too superficially (close to the skin's surface).    The deeper these fillers are placed the less likely to have this blue-ish tint.  
It is too early to tell if this has occurred for you, as you still have some swelling from the injection.  If you have any questions, you should speak with the cosmetic surgeon who performed the injection, as they will be able to help alleviate your worries.
As an Ocular Plastic Surgeon, at Accents Medical Spa, I perform this specialized injection for many patients  fill the tear trough (area below the lower eyelid and above the cheek).  It is important for all clients to know that it can take a few days before results from these injections are noted, as it can be hidden by swelling from the injection itself.

Nima Shemirani, MD · Answer

Hi @wiserandbetter. This is a great question. The Tyndall effect occurs when dermal fillers are placed too superficially. The deeper these fillers are placed, the less likely to have the Tyndall Effect. Best of luck, Dr. Nima!

Richard J. Bruneteau, MD · Answer

Restylane is a hyaluronic acid dermal filler that’s
associated with excellent clinical results and high patient satisfaction
rates.It’s easily injected and has a
smooth soft presentation.Restylane is
very versatile and can be used in multiple anatomic locations.When the eyelids are treated, it’s important
to be cautious for several reasons.In
this area the anatomy is very complex and the skin is very thin.Superficial
injections can be associated with several problems.These include lumps, bumps and skin
discoloration.When Restylane is placed
in a superficial location above the muscle, a characteristic bluish
discoloration of the skin may occur.This problem can usually be avoided by injecting the Restylane beneath
the orbicularis oculi muscles. For
these reasons, deeper injections are often more effective then superficial
injections when treating tear trough deformities.These injections should be placed beneath the
muscles and small volumes should be utilized.It’s
important that these issues be discussed with your physician before proceeding
with Restylane eyelid injections.Your
physician should be able to explain his or her approach and alleviate your
anxiety.

Harold J. Kaplan, MD · Answer

Injecting under the muscle in the tear trough area of the eye should avoid the possibility of the Tyndall effect. If the "under the muscle" technique was used by your injector and you are still seeing bruising, you can either wait several weeks to see if it resolves or seek out a physician with a pulsed dye laser to resolve the bruising more quickly.
Feel free to ask your injector about the Tyndall effect and if that is what's happening with your procedure. More than likely, he/she will want you to wait a couple weeks to see if the bruising resolves.

Michael A. Persky, MD · Answer

Hi Wiser and Better,
The Tyndall effect is avoided by injecting hyaluronic acid fillers below the muscle when filling a lower eye lid hollow.
I, too, hope that when your swelling goes down, the "bruised" look goes away. Good luck and be well.
By the way, have you looked in your mirror lately, your picture looks feline, I haven't heard of that side effect yet.
Dr. P

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How to Avoid the Tyndall Effect?

Answers (9)

Answer: Tyndall Effect for Tear Troughs

Answer: Tyndall Effect for Tear Troughs

Answer: Is Fur and Looking Like a Cute Kitten a Side Effect of Injectables?

Answer: Is Fur and Looking Like a Cute Kitten a Side Effect of Injectables?

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Our mission is to create a world where every investment in modern beauty is Worth It.