Lumps under eyes a year after filler and not getting better. No doctors have been able to help (Photo)

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.

Thank you for send the pics. I think the old filler is probably all gone since volbella doesn't last this long. You will need in person consult to determine the best treatment plan but I think combination of microneedling and/or laser and then filler again can smoothen out the areas. 

This is a very well known entity with HA fillers- seen mostly in the Vycross range from JUVEDERM. Every single specialist will know about this, and your injector should be well versed in regards to this uncommon (Specialists will see 3-4 reactions annually), but well know reaction. This is a delayed cross antigenic cross reaction with filler and another protein molecule. The standard of care is to exclude other possible antigens (rare), and treat accordingly. Vycross HA fillers break down with time and can change their antigenic profile, they are also known to migrate (despite Allergan denying it). Several schools of though regarding management of this condition - and currently there are no Gold Standards. Your injector can dampen down the immunes system providing all other exogenous causes are eliminated (bacteria, Typical and Atypical mycobacterium etc...), or have the area Hylased. Sometimes a combination of two are needed. I disagree with the statement that Volbella only last 12 months, I realise this is the COMPANY guidelines, however in Australia I have been using this filler for over 5 years. It can last over 3 years. The history of fluctuation with immune change (when you are ill) is classic of this entity. I do agree that Hylase in higher concentration is a sensible option. Dr Davin Lim, Brisbane. Australia