I have a granuloma from old tear trough filler. Can I get another steroid injection without dissolving the new filler?

Yes, you can get another steroid injection. However, repeat steroid injections may plateau in terms of benefit and can thin the soft tissue and skin. In some cases, granulomas at the site of dermal filler injections occur due to a localized infection or bacterial contamination. Typically this is treated with antibiotics and dissolving the filler, as was done in your case. Unfortunately, this area of inflammation can cause scar tissue to form and that can become noticeable when filler is reinjected into the area because the underlying tissue is tethered. Generally, this scar tissue softens over the course of about a year, but scar massage and steroids help. So while you can get another steroid injection, you may not notice that it improves the area much more. If the underlying tissue is scarred in and causing a tether, it may be worth considering a scar release procedure and placement of filler or fat grafting.