Reoccurring chemical burn feeling (redness and swelling with scaling) under eye 4 months after tear trough fillers (Photo)

Given the recurring nature of these symptoms and their persistence for over four months since the procedure, I recommend the following:

1. Schedule an immediate appointment for a comprehensive evaluation of the patient's symptoms and the affected area. This will help in determining whether the symptoms are related to the filler or possibly an allergic reaction.

2. Consider referral to a dermatologist for further evaluation, especially if the symptoms persist or worsen.

3. Discuss the possibility of hyaluronidase treatment to dissolve the filler, if it is deemed to be the cause of the recurring symptoms.

4. Continue avoiding any potential irritants and to use a gentle, hypoallergenic moisturizer instead of Vaseline, which can sometimes be occlusive.

5. Consider prescribing a topical steroid to help manage the inflammation and discomfort in the short term, pending further evaluation.

6. If the problem is not resolved or continues to recur, you should be advised about the potential risks and benefits of continuing with the fillers.

I would suggest removing the filler with enzymes and avoiding this type filler anywhere on your face or neck in the future. The one filler later you could try is Sculptra since it is a different composition and nature, but I would not try it around the eyes first.