Background Hyaluronic acid filler treatments are a very popular nonsurgical procedure worldwide, most wanted to create a more attractive profile and correct facial aging. Since its usage has expanded, more complications have been seen. Aims To report a probably new adverse effect related to injectable fillers. Patient A 38‐year‐old white woman who underwent hyaluronic acid filling in the periorbital area and presented twelve months after with two symmetrically yellowish plaque lesions on the lower eyelids, with no edema or nodules. Results The lesion appeared to be xanthelasma, in a patient with no history of hyperlipidemia. Histological analysis showed unspecific findings with rare histiocytes present in the papillary dermis. The patient was treated with hyaluronidase infiltration in both lower eyelid areas as an attempt to minimize the appearance of the lesions, with a satisfactory response. Conclusions As hyaluronic acid fillings are becoming more popular, all physicians have to be aware of its complications. The xanthelasma‐like reaction is probably a new adverse effect related to injectable fillers and it is important to be alert to this possibility.