Why do I still have puffy eyes as It's been a 14 months? (Photo)

Hi,
I think your eyelid looks very good, foremost. There is some puffiness. As a rule of thumb, whenever there is puffiness after filler, the cause is the filler. It doesn't matter what a scan shows. It's the filler. I really would not entertain otherwise unless you inject multiple tissue layers with hyaluronidase and it is still swollen. And if it still swollen after that, I would... inject in multiple layers again.
You might be disappointed after dissolution of filler, because it may leave the skin "baggy" or reveal some volume deficits. You might even want to have some filler re-injected in the deep planes after everything settles out.
Good luck,JDW

Longterm filler problems include migration, edema, and nodularity. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

If it's due to the filler, you may try dissolving it. Please contact a qualified provider or a board-certified physician with extensive experience in these procedures.