Do I require more tear trough filler or cheek filler to add volume to my right side which appears to have 2 eyes bags? (Photo)

Hello, and thank you for your question. It is difficult to determine if you would need more filler or if filler needs to be dissolved without seeing you for an in-person consultation. Per the picture, you may in fact have too much filler placed, which is making the issue appear much worse. If too much filler is placed or not placed correctly, it can create additional issues. You may need to get the filler dissolved and this may correct the issue. If more needs placed, I usually always recommend starting with cheek filler as this can inadvertently help with under eye concerns. I would recommend scheduling an in-person consultation with a provider who specializes in placement of filler as well as dissolving. Hope this helps!

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

This kind of post-filler under eye puffiness may be due to, either too superficial placement of the filler when the tear trough was treated or to choice of an inappropriate filler for this particular location. Both of the aforementioned can result in a obstruction to the lymphatic drainage in the area and to subsequent "puffy pillow"-like swellling that can be quite difficult to treat. I have personally had success in shrinking these lumps using hyaluronidase along with varying amounts and combinations of anti-inflammatory agents. Make sure to consult with a board certified cosmetic dermatologist with experience in treating this kind of issue. Best of luck.