Nasolabial filler over a year after Juvederm. Does anyone know what this is? (Photo)

At least from the photo, as well as the history of persistence following the filler, an under eye "puffy pillow" (or lyphatic obstruction; lymphedema) is a reasonable possibility. This is often caused by an inappropriate choice of HA filler and/or too superficial placement of the filler in the vicinity of the under eye. In this case, there may have been migration of the filler. If so, it is usually quite difficult to treat and even surgery is typically not successful or even recommended to address this. I have had success using various combinations and concentrations of anti-inflammatory agents in combination with varying concentrations of hyaluronidase. Make sure to consult a board certified cosmetic dermatologist. Best of luck.

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Hello and thank you for your question. A face to face consult and examination is always best however in this scenario it could be filler related or not. If it is filler it could be a delayed onset nodule which can occur at this timeframe. A face to face examination should be able to pick up on what it is and whether it is amenable to dissolving. Please always seek treatment from a trained medical professional for any cosmetic treatment. Best wishes