Undereye filler gone wrong? (Photo)

I'm sorry to hear that you're experiencing these issues. Here are some possibilities and steps to consider:

Potential Causes:
1. **Incomplete Dissolution of Filler:**
- It's possible that the cannula may not be precisely targeting all of the filler material, especially if it has migrated or is in a difficult-to-reach area.

2. **Lymphatic System Issues:**
- If the lymphatic system is compromised or not draining properly, it could contribute to persistent puffiness. This might not be directly related to the filler but could be exacerbated by the initial treatment and subsequent dissolving attempts.

3. **Inflammation or Scar Tissue:**
- Repeated injections and dissolving agents can cause inflammation or scar tissue, which might be contributing to the puffiness.

4. **Allergic Reaction or Sensitivity:**
- Although rare, some individuals might have a reaction to the hyaluronidase (Hylenex), which could cause persistent swelling.

Recommended Steps:
1. **Consult a Specialist:**
- Seek out a highly experienced dermatologist or plastic surgeon who specializes in filler complications. They may offer a more precise diagnosis and treatment plan.

2. **Ultrasound Imaging:**
- An ultrasound can help visualize any remaining filler, fluid collections, or other tissue abnormalities that might be contributing to the puffiness. This can guide more accurate treatment.

3. **Manual Lymphatic Drainage:**
- A specialized massage technique performed by a trained therapist could help reduce swelling if the lymphatic system is compromised.

4. **Time and Patience:**
- Sometimes, the body needs more time to fully resolve these issues. Minimizing additional interventions might help reduce inflammation and allow natural healing processes to take place.

5. **Hydration and Diet:**
- Ensure you are well-hydrated and consider reducing salt intake, as this can contribute to puffiness.

Mental and Emotional Well-being:
- It’s important to address the impact on your confidence and mental health. Consider speaking with a counselor or therapist to help manage the emotional stress related to this situation.

Follow-up:
- Schedule regular follow-ups with your healthcare provider to monitor the situation and adjust the treatment plan as necessary.

Remember, while it can be frustrating, many cases of filler complications can be resolved with the right approach and expertise.