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Prevention and Management of Complications
Published in Yates Yen-Yu Chao, Sebastian Cotofana, Anand V Chytra, Nicholas Moellhoff, Zeenit Sheikh, Adapting Dermal Fillers in Clinical Practice, 2022
Yates Yen-Yu Chao, Sebastian Cotofana, Nicholas Moellhoff
The Tyndall effect is named after the Irish physicist John Tyndall for his description of light being scattered by small particles. The intensity of scattering reflection is inversely proportional to the fourth power of the wavelength. That is why blue light is more scattered than the red light. By definition, Tyndall means the scattering of particles in size near the wavelength (40–900 nm); Rayleigh scattering means that phenomenon by particles smaller than the visible light wavelength and is weaker in intensity. HA particles are much larger and the bluish hue when fillers are implanted superficially also result from the colloid scattering.
Dermal filler complications and management
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
The Tyndall effect is a phenomenon which happens when light is scattered by particles in a colloid solution. As this isn’t a physics textbook we shan’t dwell on the science behind it too much, just note that in colloid solutions blue light is scattered more greatly than red. This means that clear colloid solutions such as dermal fillers can appear blue. The relevance of this to your cosmetic practice is that dermal fillers are a colloid solution and therefore can develop a bluish hue and discolour the surrounding skin. In the acute phase, the Tyndall effect is often mistaken for a deep bruise; however, the primary discerning feature is that unlike a bruise this will not resolve spontaneously over the next few weeks (Figure 13.4).
Periorbital Region and Tear Trough
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Colin M. Morrison, Ruth Tevlin, Steven Liew, Vitaly Zholtikov, Haideh Hirmand, Steven Fagien
Visibility of product may occur [6]; deep injections reduce the risk, but in rare cases, underlying tissue characteristics may predispose to visibility regardless of technique [2]. Persistent and delayed edema may accentuate this complication. Visibility may be associated with a gray or blue color, a refractive phenomenon known as the “Tyndall effect.” Patients who are photographed professionally may show skin surface deformities that are only visible temporarily during flash photography and should be forewarned. Sometimes this bluish hue cannot be avoided and should be discussed with patients prior to injection. In some cases, anterior migration of hyaluronic acid (HA) may ensue over time, causing more of a bluish hue. This problem may be addressed by dissolving the HA product with hyaluronidase.
Correlation of Clinical Aqueous Flare Grading to Semi-Automated Flare Measurements Using Laser Flare Photometry
Published in Ocular Immunology and Inflammation, 2022
Muhammad Sohail Halim, Murat Hasanreisoglu, Neil Onghanseng, Anh N.T. Tran, Muhammad Hassan, Mervenur Yilmaz, Asadu Segawa, Gokhan Gurelik, Rubbia Afridi, Maria Soledad Ormaechea, Gunay Uludag, Cem Kesim, Nam V. Nguyen, Jeong Hun Bae, Jung Huynh Park, Diana V. Do, Mohamed A. Ibrahim, Yasir J. Sepah, Quan Dong Nguyen
Aqueous flare is an observable sign that occurs when there is an increase in the concentration of proteins in the anterior chamber as a result of a breakdown in the blood aqueous barrier, leading to decreased clarity of the aqueous humor. Attempts to shine light through the aqueous humor leads to increased light scatter with increasing protein concentration due to the Tyndall effect. Utilizing the knowledge of this effect, ophthalmologists have created various ways to measure aqueous flare with most of the initial methods based on the creation of a subjective grading scheme. Subsequently, various grading schemes were collated by the Standardization of Uveitis Nomenclature (SUN) Working Group to create the current subjective system employed by ophthalmologists today.1, 2
Evaluating safety in hyaluronic acid lip injections
Published in Expert Opinion on Drug Safety, 2021
Tyler Safran, Arthur Swift, Sebastian Cotofana, Andreas Nikolis
Skin discoloration at the injection site was described in few patients both in the case reports and the larger studies. Tyndall effect occurs when filler is placed too superficially in the dermis causing long wavelength blue light to scatter and yield a bluish hue discoloration, described also as Raleigh Scattering. If not treated, superficial product has been shown to stay visible for multiple years [43]. Hylaronidase in this setting can be used multiple times to dissolve HA placed superficially. One technique described is starting with 30 units and then seeing the patient back in 3–4 days for reevaluation. A Q-Switched 1,064 nm laser device or direct incision and drainage are also described treatments [43]. Every patient with non-blanching, Tyndall effect or significant ecchymosis should be followed to rule out an arterial (see arterial injury section) or venous complication.
Complications associated with infraorbital filler injection
Published in Journal of Cosmetic and Laser Therapy, 2020
Shivani Reddy, Tuyet A. Nguyen, Nima Gharavi
The blue-gray hue, otherwise known as the Tyndall effect, is more pronounced in patients with thinner, lightly pigmented skin. To minimize blue-gray hue and contour irregularities, injections should not be placed too superficially (13). It is more ideal to place the filler in small amounts, in a cross-hatched pattern, below the orbicularis oculi muscle or in the pre-periosteal plane (1,10). In some cases, the filler product can migrate anteriorly over time and cause worsening of the blue-gray tint effect. Contour irregularities, which can occur as an early or late manifestation, most commonly appear over the inferior orbital rim, creating the appearance of an orbital ridge (11). They may also appear as nodules, which can be massaged or injected with hyaluronidase to be dissolved altogether (1). Overcorrection or asymmetry may be corrected with hyaluronidase as well.