Malar bags or badly placed filler - how can I improve this area? (Photo)

Thank you for sharing your photo and your history so clearly, it really helps paint the picture. What you’re describing is something I see quite often, and I completely understand your frustration. The under-eye and midface area is delicate, and treatments there can sometimes bring mixed results, especially if there’s an underlying anatomical predisposition.

From what you’ve described, it does sound like a combination of two things may be at play: natural malar bags (which are related to the way the fat pads and ligaments sit in the midface) and possible filler presence or migration. Malar bags often become more prominent with age or genetics, and fillers in the wrong plane can sometimes highlight them rather than smooth them out.

You’re absolutely right that dissolving filler can sometimes leave the area looking hollow, which can feel discouraging. It doesn’t necessarily mean you’re “stuck” this way, it just means your treatment approach may need to shift away from filler alone. Options like energy-based devices (such as Morpheus8, which uses radiofrequency microneedling) may help tighten the skin and improve the appearance of puffiness, but they don’t typically address the deeper structural cause if it’s true malar bags.

Other approaches that can help:

Surgical options (like lower blepharoplasty or fat repositioning) – these directly address malar bags and are often the most definitive treatment.

Combination approaches – sometimes a very conservative use of filler in the right plane, paired with skin-tightening treatments, can improve contour without overfilling.

Lifestyle factors – while not the main cause, things like salt intake, hydration, and sleep quality can affect puffiness and are worth optimizing.

What you’re seeing looks less like “bad filler” and more like a combination of natural malar bags with the history of filler making them more noticeable. Morpheus8 could help with skin quality, but if your main concern is the persistent bulge, more targeted treatments (like surgical correction or fat pad repositioning) may give the most satisfying outcome.

It’s important to know that this isn’t something you caused or that was “done wrong” the under-eye region is just very challenging to treat with filler alone.

As long as you continue to inject hyaluronic acid fillers, you’re so-called Malar Bags will not resolve. My advice to you is to have the hyaluronic acid filler completely dissolved, but with small amounts of hyaluronidase and then follow up with fat grafting. I hope this helps and good luck from Leonard Grossman, MD, organic Plastic Surgery New York City.