Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Tyndall, Bruise or Possibly Ischemia Following Silk Injection to Forehead

Q. Bruising or Tyndall Effect from after Restylane Silk injected in my cheeks and forehead today? Today I had some restylane silk injected into my cheeks and some some on my forehead. I’m noticing this reddish mark that goes upwards from a point of injection. (The redness higher on my forehead is from my hat, the area I circled is what appears to be a bruise). I don’t want to jump to any conclusions and my first thought is that this is just a small bruised area from the injection point. Are there any obvious differences between brushing and the Tyndall effect?

A. Thanks for sharing your photos. These are helpful. You need to revisit your injector immediately. 

Based on the information provided, this occurred somewhat immediately following injection. The vertical and horizontal marks appear reddish and not blue (tyndall) or purple (bruise) in the photos.  Presuming the injection was for horizontal lines across the forehead, the vertical oblique patch maybe a small vessel occlusion creating ischemia and reactive hyperemia, ie. blockage of a blood vessel with a increased blood perfusion response. 

While the majority of these occurrences resolve without complications, increasing concerns are popping up in the literature of blood vessel occlusion following filler injection. Skin necrosis may occur without adequate circulation. Blindness and stroke would be a concern if the occlusion were to travel toward the eye.

If your injector is not Board Certified in Plastic Surgery or Dermatology, or does not know what to do for this kind of complication, proceed to the nearest Emergency Department for evaluation and care. 

Read more about similar topics:

Filler Occlusion

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

Give us a call at  410.602.3322  or email and make an appointment soon. We’re located on Reservoir Circle just a block off the Baltimore beltway, convenient to greater Baltimore, Annapolis, the Eastern Shore, Southern Pennsylvania, Delaware and Carroll County.

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