Eye bags worse after filler Restylane under eyes. Is it fluid or fat? Is surgery a good choice? (Photo)

This may be due to placement. If you're unhappy with your results, the filler can be reversed. Surgery is an alternative. Surgery would require a fat-repositioning lower lid blepharoplasty. In this surgical procedure, fat from the eye area is moved into the tear trough depression filling the actual depression. 
I hope this helps!

Thank you for your question. There are many things you can do to treat under eye bags, but a combination approach with nonsurgical treatments would give the most improvement: fillers (Belotero, Juvederm Volbella), lasers (Fraxel/CO2), Renuvion (J-Plasma), microneedling/PRP, Cosmelan peels and stem cells. A surgical option to remove skin and/or fat might be the best solution long-term. I suggest getting a formal evaluation with a cosmetic dermatologist to see what is best for you and your goals. Best, Dr. Emer.

From you photo it appears that your lower eye bag is either fat or filler, not fluid. The filler can be removed with a Wydase injection. After the filler is "dissolved", an evaluation by a surgeon can be helpful for you to determine if fat removal would be beneficial for you. 

In the right patient lower eyelid surgery can be a nice, permanent solution to bags under the eyes.  Fillers can work well in many patients but may not provide the expected results and they are temporary.  If you still have filler in your lower eyelids from a previous injection, surgery should be contemplated only after the filler is gone either through time or by an injection of hyaluronidase to dissolve the filler.You should have a few consultations with board-certified surgeons who are experienced in treating the eyelids.  Ask to see their before and after pictures and make sure you feel comfortable with the surgeon you choose.  Best of luck!

That looks like lower lid fat.  If you had filler and didn't like it, I am assuming you had it removed with an injection of hyaluronidase.  If you didn't, it is best to have that done before lower lid surgery.  Another injection may also make the area look better if there is any filler in there.  Any residual HA filler will come out during a surgery, so you could have a blepharoplasty at any time. 

Puffy eyelids are most often caused by bulging of the fat which supports the eyes. Certain anatomies of the lower eyelid region predispose young people to this deformity. Loss of volume of the bony infra-orbital rim accentuates this tear trough in older individuals.                                                                                 Surgical correction using a LASER to melt the fat may be performed from inside the eyelid leaving no visible scar or with an incision just below the lashes permitting removal and tightening of excess skin. Surgery with repositioning of the lower eyelid fat is the most successful option; performed with local anesthesia and mild sedation $2900.                                                                                        Various non surgical options are available. The most common is injection of filler below the lids and the tear trough.  Hyaluronic acids (Restylane, Juvederm) are most commonly used as they correct the majority of the defect.and last well in this area. The addition of PRP or Stem Cells to the injection can help to lighten  and smooth the skin of the area as well as prolong the duration of correction. Hyaluronic acids may cause a bluish discoloration when injected under the lids. Techniques exist to decrease the probability of this occurring. Over correction resulting in bumps is not rare. These are easily corrected with an injection of Hyaluronidase. Fat injections with their stem cells are more long lasting solutions; in addition correcting the defect they help to improve the color and quality of the overlying skin. This is very cost effective as it does not require the purchase of any injectable and usually lasts for the long run.                            Eyelid bags may be successfully diminished by injection of a few solutions. One to a few sessions result in long lasting correction.                                               Please consult with an experienced Board Certified Plastic Surgeon prior to making treatment decisions.

Given your photos, it is not surprising that filler did not fix the problem.  Lower eyelid blepharoplasty would remove the fat and the bulges directly.  Evaluation in the office would also tell if you needed more cheek support or lid lid support as well.  It's been 5months and 6 months would be ideal.  Hope that helps!Dr. Z

Filler gradually breaks down after 9 months to a year.  It is used to disguise under eye irregularities, but the underlying original issue doesn't change.  If you were unhappy with filler you may want to consider lower blepharoplasty which will remove excess fat and skin, revealing a smoother under eye area.

Restylane is a temporary fix to camouflage eye bags . It is always temporary , does not always correct the original problem and ,on occasion, can make it worse. Surgical correction is the optimal way to improve this problem, but should not happen until the filler has spontaneously dissolve down over a 6-19 month period, or after an injection of hykauronic acid which can dissolve the filler to then allow the surgeon to see the uncorrected anatomy ,thus allowing a plan of correction.
Be sure to obtain a consultation with a Board certifeid Plastic  Surgeon.

Thank you for sharing your concerns
They are fat bags. You will benefit from hyaluronidase injection first. Followed by lower eyelid surgery to correct your bags

Sincerely
GD