9 years after under eye and nasolabial fold filler, could it still cause an infection this far post op?

I understand your concern—it can feel unsettling to still notice filler many years after placement, especially when you’re now experiencing discomfort. While hyaluronic acid fillers like Restylane are designed to gradually dissolve over time, in some cases, they can persist much longer than expected, especially in areas with less movement such as under the eyes.

A sudden onset of pain at the site is not something to ignore. True infections this many years later are very rare, but late-onset inflammatory reactions, filler migration, or even delayed nodules can occur. These reactions can mimic infection and cause tenderness or swelling.

It’s important to have the area carefully evaluated to determine if what you’re feeling is related to the filler itself, an inflammatory response, or a different issue altogether. In some situations, hyaluronidase may still be considered if the filler is contributing to your symptoms, and it can be used very precisely when done by an experienced injector.

You’re not alone in this—many people share similar worries about filler longevity and complications. The key is getting a thoughtful assessment so the right next step can be taken.

Given the amount of time that's passed since having filler placed, it's unlikely that it is infected. However, even hyaluronic acid-based fillers can cause nodules or granulomas to form. This may be what you are experiencing.

See a local dermatologist or plastic surgeon for evaluation and management.

An in person evaluation is needed to determine what may be causing your concerns. It would be uncommon for filler injected nine years ago to still be present and causing issues. A board certified plastic surgeon should be able to give you recommendations after an examination.