What is the best treatment for edema in lower lids after Voluma, where residual edema isn't responsive to hyaluronidase?

Hi @123okay. I recommend Morpheus 8. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting. Best of luck, Dr. Nima!

Thank you for your question. If you are sure that all of the HA product has been dissolved, then the only answer for you is time. I would not go chasing the swelling with other products or treatments that risk causing additional problems. Be patient and it will improve with time.Good luck!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Assuming all of the filler has been dissolved, any remaining edema maybe the result of lymphatic disruption/injury. When the lymphatics are injured, it can take some time for the edema to resolve on its own. I prefer Restylane when treating the tear troughs. Voluma, in my opinion, is not a good choice for the undereyes. 

Thanks for the question.  Unfortunately, swelling post injections in the tear-trough/lower lid area is common.  Voluma would not be my first choice to inject in this area.  The hyaluronidase will dissolve the product, but that process creates inflammation and more swelling.  A series of lymphatic drainage massage with cupping can be very effective in resolving swelling in this area.  Find an experience massage therapist that works specifically with aesthetic patients for this type of treatment.  Good luck to you.