Long-term swelling after under eye fillers

Thank you for submitting your question and photos. Long-term swelling is not a regular occurrence from dermal fillers and should be reduced by proper injection of the hyaluronidase enzyme. The swelling you’re still experiencing may have been caused by an unsuitable dosage, injection site, or formula selection. I recommend scheduling an in-person consultation with an experienced, qualified injector who can assess your swelling and suggest the best treatment options for you.

The most likely explanation for this is lymphatic obstruction, secondary to too superficial placement of the HA filler and/or the inappropriate choice of HA filler for the region that has led to obstruction of the lymphatic drainage in this delicate region and hence what has come to be known as "puffy pillows." . It is unfortunately a very difficult problem to treat. I have success with people who have been treated elsewhere with intralesional injections of anti-inflammatory agents in various combinations and concentrations. Make sure to consult with an experienced, board certified cosmetic dermatologist Best of luck.

Filler injected into the tear troughs can last for many years. Hyaluronidase should help to dissolve it but must be injected into the correct layers where the filler was placed or it won't work. Your injector may need to adjust the placement of the hyaluronidase. Tear trough injections should be done by an experienced physician.