Under eye puffiness & blue-ish hues - malar bags? What's going on? (Photos)

This is most likely from filler. I would find an experienced physician injector who can diagnose and treat this. Should be a relatively simple procedure to fix it. Best of luck.

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

I have written about this condition many times before. It may well be, Under-Eye Puffy Pillows, or lymphedema (lymphatic obstruction), which can follow--even long afterward--the use of the use of an inappropriate HA filler for the tear troughs and/or too superficial injection of the filler in the delicate under eye tissues. It may occur long after the treatments and is typically very difficult to treat. I have had gratifying results treating patients who have come to me with this problem using an algorithm of varying combinations, concentrations, and amounts of intralesional anti-inflammatory agents. Make sure to consult with a board certified cosmetic dermatologist with experience with this issue. Hope this helps.

In general, undereye HA fillers may last years, and a puffy bluish tint may be the Tyndall effect. That’s associated with HA below thin eyelid skin. You may consider getting the HA dissolved.
A Consultation with a reputable dermatologist or facial plastic surgeon should be helpful. Good luck! Dr Joseph

It is possible for old filler to cause swelling. Fortunately, it is easily treatable with a very gentle amount of product that can be placed very shallow to settle down any surface filler that may be the cause this problem. Good luck!!

Thank you for your question as to what might be causing the bluish discoloration under your eyes. Even before seeing your photos, your description kind of said it all. You had fillers, some time went by, now you have puffiness and there is a blue hue. The blue appears to be what is called a Tindal sign. What that means is that it is well known what some types of hyaluronic fillers might look like if they have found their way close to the surface of the skin. It makes a difference where fillers are placed. If they are placed superficially they are more prone to migrate. In the under-eye area filler might more often be better placed all the way down on the periosteum of the bone. Someone not really familiar with anatomy and versed in medical details might not know about that or be experienced with that. Plus, fillers can and do migrate from where they were first put. Some, that so-called integrate well into the skin, also migrate well to other places. I have seen this type of thing very often from other practices and we have always been able to help. You can see a physician versed in treating with fillers for years or decades and they can review recommendations with you. For example, hyaluronic fillers can be dissolved with an enzyme called hyaluronidase. The one I use is Hylenex. As with fillers, it is not an all or none thing. The more filler one wants to dissolve, the more hylauronidase one needs to use. There is craft involved in getting rid of filler. One should then wait a bit, at least 2 wees or maybe longer, before using any more material near the area treated. Also, if your physician feels there is a component of allergy going on they could consider treating that to help reduce the puffiness.Keep in mind my comments are in general and are not meant to diagnose you nor to give you treatment options, nor treatment. Best of luck.

We have MRI evidence examples now that filler may last years and even decades. There are also examples of fillers causing on-and-off puffiness years after injecting. This is by far the most common explanation. Botox on the forehead is unlikely the cause. however, if you did Botox under your eyes that can relax the orbicularis muscle and cause puffiness, then it will be gone in a few months. Best of luck!