How to correct under eye bags and darkness caused by filler and Lupus? (Photo)

It sounds like you're dealing with a combination of factors that make the under-eye area particularly sensitive, especially with your history of using prednisone for Lupus and the laser treatment. Here are some considerations based on your situation:

1. Lower Blepharoplasty:
Surgical Option: A lower blepharoplasty is often recommended for patients with persistent puffiness or under-eye bags that don't respond to non-surgical treatments. This surgery removes excess skin and fat to smooth out the under-eye area. It can be a permanent solution, but as with any surgery, it's important to weigh the risks and recovery time, especially considering your autoimmune condition.
Is It Your Only Option?: While it's a more permanent solution, it's not necessarily your only option. Some non-surgical treatments may still be viable depending on the extent of the puffiness.
2. Eye Light Ultra:
Non-Invasive: If you're exploring Eye Light Ultra, this might offer some non-invasive relief. It combines infrared light and radiofrequency to improve skin texture, firmness, and puffiness around the eyes by stimulating collagen production. It's a safer, non-invasive option compared to surgery, but the results may be more subtle and may require multiple sessions.
3. Prednisone Impact:
Fluid Retention: Prednisone can cause fluid retention, which might contribute to the puffiness under your eyes. This could explain why, after the emotional event, the swelling never fully went away. Managing the prednisone dosage with your doctor or finding alternative medications (if possible) might help reduce this side effect.
4. Hydroquinone and Laser Burn:
Hydroquinone for Pigmentation: If the darkness under your eyes is related to a laser burn, Hydroquinone can be effective for lightening pigmentation over time. However, be cautious with long-term use, as hydroquinone can cause irritation or rebound pigmentation. It's important to use it under a doctor's supervision, especially on sensitive areas like the under-eye skin.

So the lupus makes you more at risk for any sort of inflammatory reaction to fillers, and anything really even lasers, so you have to be extremely careful. Due to the lupus depending which variant you have Can also have unexpected inflammation or clotting that can occurYou would have to talk with your doctor and see what is the expected inflammatory response with a blepheroplasty. It Might be better to just melt it with hyaluronidase understanding you may have unexpected more than usual inflammation initially underlying that will go down. I would not put anymore dermal filler. Mineral sun block every 2 hours and be really careful about choosing what makeup you put under your can have unexpected inflammatory response which can always lead to dark circles. If you suffer from allergies and lacrimate often may wany to consider seeing allergist to control allergies as irritation from allergies can worsen dark circles

Based on your photos and issues with previous filler treatments a lower blepharoplasty would likely give you the best results. Be sure to discuss your medical history as well as the medications you take with your surgeon. I've included a video on the procedure that I hope you find helpful.