Steroid injection into puffy eye bag? (Photo)

If it is old restylane or other hyaluronic acid filler, this will go away on its own. Hyalenx can help knock it down very quickly. Steroid will just thin your skin, which is not beneficial. Wait until the old filler issue is resolved before moving forward with any fat grafting or other interventions to improve your appearance. Best wishes! Dr Camp

It you did not have this puffy before a hyaluronic acid filler service and now you have it, then sure, hyaluronidase is the answer. If you have always looked like this and have never, ever had hyaluronic acid filler, then there is no reason on earth to have hyaluronidase. To not let a bozo inject your lower eyelid with corticosteroids. They kill fat in a very unpredictable way. You will then feel compelled to do something goofy to address the dent. Don't fall into a vicious downward spiral. Your prior post suggest you have had Radiesse in this area-bad product for this area. It will absorb on its own over about a 1 or 2 year period. Enzyme will not do anything for funky Radiesse. Generally you could have a correcting Restylane treatment to bend this area. That is likely the safest approach.

If you had previous filler then Hylenex would be a good option to dissolve everything and start fresh. Steroid injection will not help in your situation. I would recommend lower eyelid blepharoplasty with fat transposition to rotate the fat into the tear trough to fill the hallow. You should see an eyelid expert in your area.
Best of luck!

Without an exam, it is impossible to comment specifically. However, I can think of no reason to use a steroid in this area except for a very specific granuloma and I can think of many possible problems. If the puffiness you are worried about is that between the 2 depressions (orbital rim and lower eyelid border) then your problem is probably from injecting the wrong filler in the wrong place producing edema (swelling) from disruption of the under eye lymphatics. If the filler is really "old," hyaluronidase will not do anything and the only option is to simply wait for the filler to wear off.