I had tear trough filler (Panda eyes) injected previously; the first time went smoothly, but after the second session, it suddenly became inflamed and swollen. It has been two years now, and a lump appears whenever I smile, which often turns into a visible line when pressed. It’s very bothersome. Doctor, what methods can be used to dissolve it?

Hello, I understand how distressing this situation can be.

Direct Answer: Panda injections (熊貓針) are fundamentally collagen-based implants rather than hyaluronic acid (HA). Therefore, standard hyaluronidase (dissolving enzyme) is not the direct method for handling this type of material. Since it has been two years, with bumps appearing when smiling and lines forming upon pressing, the first step is to determine what is actually inside rather than immediately opting for so-called "dissolving."

Possible Scenarios to Differentiate
Given that you experienced sudden inflammation and swelling after your second treatment, and bumps still persist two years later, the causes could be:
1. Residual material
2. Displacement
3. Fibrosis or encapsulation
4. Post-inflammatory tissue changes
For filler issues that have already formed nodules or encapsulation, enzyme treatment is naturally limited in its effectiveness.

General Treatment Direction
- The under-eye area is a very delicate region. The truly appropriate approach requires an in-person evaluation. When necessary, an ultrasound should be used to clearly observe the tissue planes, extent, and internal properties before deciding on the subsequent approach, which is much safer. Issues in the under-eye area require millimeter-level localization and judgment via ultrasound.
- During your consultation, regardless of which medical clinic you visit, it is recommended to prepare: injection dates, product names and dosages, and current photos of your face.

When to Seek Immediate Medical Attention
If the under-eye area suddenly becomes red, swollen, hot, and painful again, shows skin discoloration, or if you experience changes in vision, please seek medical attention immediately.

Online responses are for general health education purposes only and do not constitute a diagnosis, nor can they replace an in-person consultation and ultrasound examination.