u/Weary-Height5782

I had tear trough filler done once in 2023. Unfortunately, it resulted in lumps, and the filler never really looked right. Then, after losing 24 kg last year, I started noticing a very obvious Tyndall effect as well. This is what my under-eye area looks like now (see photos).

What would you do in my situation? I’m really nervous about getting hyaluronidase because of all the horror stories I’ve read on this forum about dissolving filler.

I'm 37, and the last five years have been really hard on my skin. I had twins born 3.5 months premature, developed acne at 34, went through cancer treatment, and lost 53 lbs. I used to have clear, low-maintenance skin, but that's no longer the case.

You guys always come up with great advice, so if there's anything you'd add to my routine (or change), I'd love to hear it!

My current routine:

Morning

Gentle cleanser

Beauty of Joseon Green Tea + Panthenol Serum

LED face mask

Azelaic acid 15%

Basiderm Oil Control Daily Moisturizer SPF 30 (I use SPF 50 if I'm going to be outside for longer)

Evening

Gentle cleanser

Azelaic acid 15%

EDO Nobody's Perfect Face Cream or Basiderm Microbiome Equalizer

Doxycycline pill (for acne)

Once a week

The Ordinary Retinal 0.2% (just started, so I'm introducing it slowly)

My biggest concerns are persistent adult acne, my post-acne marks, skin texture, and some loss of firmness after weight loss.

I know tretinoin is a popular recommendation here 😊 Unfortunately, it's not something that's easily prescribed where I live in Scandinavia, and my dermatologist doesn't think my acne requires stronger treatment than what I'm already using. So tretinoin isn't really an option for me at the moment.

I'm 37 years old and lost 53 lbs on Wegovy last year. Afterwards I developed facial volume loss and I hate how my face looks now :(

I had HIFU about a year ago with no visible improvement. More recently, an experienced cosmetic nurse assessed me and recommended a full course of Profhilo Structura for the volume loss, but unfortunately I didn't see any noticeable improvement from that either.

At this point I'm trying to figure out what the most appropriate next step would be. Does this look like something that might respond to filler, HArmonyCa, Radiesse, Sculptra, surgery, or something else? I'm especially interested in hearing from people who have experience treating or correcting weight-loss-related facial changes. ❤️

I'd really appreciate any thoughts on what you think would actually address this, given that both HIFU and Structura failed.

Edit: Pictures on the left side are before weight loss and pictures on the right are after