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Tyndall Effect and Under-Eye Filler Complications: What to Do
Under-eye filler treatment is among the most requested aesthetic procedures to refresh one’s gaze and reduce signs of fatigue. However, as with any medical procedure, it’s essential to be aware of potential complications. One of these although not dangerous but aesthetically unpleasant is the Tyndall effect.
At Image Regenerative Clinic, under the scientific direction of Professor Carlo Tremolada, we place the utmost attention on safety and the harmony of results. We deal daily with the complexities of regenerative and aesthetic medicine, offering advanced solutions both for those who wish to enhance their appearance and for those who need to correct the outcomes of previous treatments.
What Is the Tyndall Effect in Fillers and How It Manifests
The Tyndall effect is an optical phenomenon that occurs when a hyaluronic acid–based filler is injected too superficially into the thin skin of the under-eye area. When light passes through the skin and strikes the gel particles, it scatters, creating an unsightly bluish or grayish discoloration similar to a persistent bruise.
It is important to distinguish it from a common post-treatment hematoma. While a bruise is caused by a small blood leak and fades within a few days, changing color (from purple to yellow/green), the Tyndall effect does not resolve spontaneously and may persist for months, sometimes for the entire duration of the filler. This abnormal pigmentation makes the gaze appear tired and aged, effectively undermining the purpose of the initial treatment.
Main Causes of the Tyndall Effect in Aesthetic Treatments
The occurrence of the Tyndall effect is not random; it is linked to well-defined factors that every skilled practitioner knows and can prevent. The main causes include:
Superficial injection: The most common cause. The skin of the lower eyelid is the thinnest in the body. If hyaluronic acid filler is placed just beneath the surface, its transparency interacts with light, producing the characteristic discoloration.
Type of filler used: Not all fillers are the same. Products with smaller or less cross-linked particles, while smoother, may be more prone to this effect if not injected at the correct depth.
Excessive amount of product: Overcorrection or injecting too much filler in such a delicate area increases the risk that part of the product will sit too superficially.
Patient anatomy:
Individuals with very thin, fair skin may be more predisposed to developing the Tyndall effect, even with a correctly performed injection.
Identifying the Symptoms: When to Be Concerned
Recognizing the Tyndall effect is the first step to treating it effectively. It is often mistaken for swelling or a bruise, but there are key differences. While it poses no health risk, the aesthetic impac, if unmanaged, can cause significant distress.
Key differences:
Characteristic
Tyndall Effect
Bruise (Hematoma)
Swelling (Edema)
Color
Bluish, grayish, purplish
Purple, bluish turning green/yellow
Usually colorless, sometimes red
Onset
Gradual; may appear days or weeks later
Immediate or within hours
Immediate or within hours
Duration
Persistent; does not resolve spontaneously
Resolves within 7–14 days
Fades within a few days
Sensation
Generally painless
May be sore or tender
Feels tight or full
A much rarer and more serious complication—not to be confused with the Tyndall effect—is filler-induced ischemia, which presents with acute pain, skin blanching, and requires immediate medical attention.
Preventive Strategies for Post-Filler Swelling Under the Eyes
Prevention is the most effective strategy. Choosing a practitioner with in-depth knowledge of facial anatomy and extensive experience in treating the delicate periocular area is crucial. An experienced doctor will know how to:
Choose the right product: Select a hyaluronic acid filler specifically designed for the under-eye area, with the appropriate density and elasticity.
Apply the correct technique: Inject at the right depth—typically supraperiosteal (in contact with the orbital bone)—to avoid visibility through the thin skin.
Use the proper dosage: Proceed conservatively, using the minimum amount necessary to achieve a natural correction and avoid overfilling.
Treatment Options to Correct the Tyndall Effect
When the Tyndall effect has already occurred, waiting for the filler to dissolve naturally is not a practical solution—it can take many months. The most effective and safest solution is the use of hyaluronidase, an enzyme capable of selectively dissolving hyaluronic acid.
At Image Regenerative Clinic, we manage this complication with the utmost precision. Hyaluronidase injections are performed under ultrasound guidance, allowing us to visualize the filler’s exact position in real time and inject the enzyme precisely where needed. Ultrasound guidance ensures that only the superficial deposit causing the Tyndall effect is dissolved, preserving the deeper, correctly placed filler and minimizing any risk to surrounding tissues. The result: a return to normal appearance within hours, in total safety.
When to See a Professional: Guidelines and Advice
If you notice persistent discoloration in an area treated with filler, do not underestimate it. Consult an experienced practitioner—ideally at a clinic specializing in the management of filler complications.
At Image Regenerative Clinic, our philosophy is rooted in regenerative medicine. For periocular rejuvenation, we offer a superior alternative that completely eliminates the risk of the Tyndall effect: Lipogems® treatment.
This patented method, developed by Professor Tremolada, uses micro-fragmented adipose tissue taken from the patient’s own body. Unlike synthetic fillers, Lipogems® is not a transparent gel but a living biological tissue that regenerates the skin from within—restoring natural volume and improving skin quality. Because it is autologous tissue and not a gel, it cannot cause light diffusion leading to the Tyndall effect, making it the safest and most natural solution for harmonious eye rejuvenation.
Frequently Asked Questions (FAQ)
What are the side effects of under-eye filler?
The most common side effects are temporary: swelling, mild bruising, and redness at the injection site. Less frequent but more persistent complications include nodules, asymmetries, and the Tyndall effect. Severe complications—such as vascular occlusion—are extremely rare when performed by an experienced physician.
What causes swelling under the eyes after filler?
Post-filler edema is a common reaction due to injection trauma and the hygroscopic nature of hyaluronic acid, which attracts water. It usually resolves within a few days. Persistent or delayed swelling may be related to inflammation or impaired lymphatic drainage and requires medical evaluation.
What damage can filler cause to the face?
If performed by unqualified personnel, filler can cause aesthetic damage such as asymmetry, nodules, granulomas (chronic inflammatory reactions), or the Tyndall effect. The most serious, though rare, risk is intravascular injection (ischemia), which can lead to skin necrosis or, in exceptional cases, blindness if vessels supplying the eye are affected.
What are the side effects of hyaluronidase?
Hyaluronidase is generally safe. The most common side effects are mild and temporary: redness, swelling, or small bruises at the injection site. In rare cases, allergic reactions may occur; for this reason, a small skin test is routinely performed before full treatment to rule out this risk.
