Hello, and thank you for your question regarding the removal of a granuloma under your eye due to Dermalive filler. It’s understandable that you are seeking a solution after such a long period. Here’s some guidance on your next steps: Consultation with a Specialist: Plastic Surgeon or Oculoplastic Surgeon: It is crucial to consult with a surgeon who has experience in dealing with complications from dermal fillers, particularly granulomas. Comprehensive Evaluation: The surgeon will assess the size, location, and nature of the granuloma to determine the best surgical approach. Surgical Options: Excision: This is a common surgical method for removing granulomas. The surgeon will carefully excise the nodule, aiming to minimize scarring and preserve the surrounding tissue. Advanced Techniques: Depending on the granuloma's complexity, the surgeon might use advanced techniques such as laser-assisted removal or other minimally invasive procedures. Pre-Surgical Considerations: Medical History Review: Ensure you provide a detailed medical history, including any previous treatments and reactions, to help the surgeon plan effectively. Imaging: In some cases, imaging studies like ultrasound or MRI may be recommended to get a better understanding of the granuloma's characteristics. Post-Surgical Care: Follow-Up Appointments: Regular follow-ups will be necessary to monitor healing and address any complications promptly. Care Instructions: Adhere to all postoperative care instructions provided by your surgeon to optimize healing and outcomes. Finding the Right Surgeon: Research and Referrals: Look for board-certified surgeons with specific experience in treating filler complications. Reading reviews and seeking referrals from trusted healthcare professionals can be helpful. I hope this information helps you in your journey to address the issue effectively. A consultation with a qualified surgeon will be essential to determine the most appropriate approach for your situation. Wishing you success in resolving this concern.