The best approach in my office is to remove the filler and wait a few weeks. In this manner the surgeon can truly examine your unaltered eyelids and offer the best approach to proceed in achieving your ultimate goal.
Thank you for your questions, yes you can have lower eyelid surgery if you will have the surgery with the surgeon that did the eyelid this might be best as he will know what way is best for you.
It is possible to undergo lower eyelid surgery after placement of fillers in the lower lids. It's probably best to have the fillers removed several weeks prior to cosmetic lower blepharoplasty procedure.
As a general rule, if you are considering having lower eyelid surgery I would have your injectable filler dissolved before proceeding with surgery. Great results from lower eyelid surgery depend on very precise and delicate maneuvers. Having filler present can sometimes lead to a result that's not quite as good as it could have been. With that said, you might want to get a second opinion on the results of your injectable filler prior to going ahead with surgery. Injecting the tear trough can be relatively difficult and it may simply be that the filler was not done perfectly and that this may be able to be improved significantly without needing more surgery. Good luck.
Can eyelid surgery be done after filler, absolutely. Should the under eyelid filler be removed before lower eyelid surgery? I strongly recommend that it the surgeon who will be doing the lower eyelid surgery did not place the product, it should be removed with enzyme and the eyelids studied after the swelling has subsides. If the surgeon who placed the product is the one who will be doing the surgery, I encourage you to seek other surgical opinions. I believe the filler product you received is sufficiently inferior to other filler products that it makes me concerned about the judgement of someone who would place it. I also suspect that you may very well have had an inferior filer service so you are making a decision about filler vs surgery without appropriate filler treatment. Consider posting photos here for more detailed input.
There are likely to be all kinds of responses to this question and ultimately will be up to the surgeon who you are placing your trust in, howeve our preferrence would be to wait out the filler and consider eyelid surgery when teh filler is gone.
I think that the filler might impact some of the surgical maneuvers that might be required to achieve your goals. Best to not have filler there if possible.
I have the filler removed with Hyaluronidase before doing the surgery. It helps to decrease the post-op edema to not have the filler there, and makes the repositioning of the fat easier.
anticspice, ultimately that decision will need to be made by the surgeon you choose to perform your surgery. I can tell you that it would not be a problem for me; I've done a "SOOF lift blepharoplasty" many times on patients who have had fillers and not found the fillers to make my dissection any more (or less) difficult. I would suggest you find a surgical specialist that does "only faces" and is familiar with the SOOF lift technique. Search the Internet and watch the video for more information. Good luck!
There is no reason why you can not have lower eyelid surgery after filler. Filler can stay there and it doesn't have to be removed (dissolved). You should discuss this issue with your surgeon. Good luck.