The tear trough, the hollow located between the lower eyelid and the cheek, is one of the most sensitive areas of the face. Its treatment with hyaluronic acid injections can, when properly indicated and correctly performed, rejuvenate the gaze subtly, without surgery.
However, this area requires an in-depth knowledge of facial anatomy, perfect mastery of injection techniques, and a keen sense of aesthetics. Hence the importance for the patient of knowing whom to trust with their face. How can one recognize a physician truly experienced in tear trough treatment? Which criteria should be prioritized? Which warning signs should alert the patient?
This guide provides a clear, structured, and objective answer to direct each patient to an experienced and trustworthy physician.
Treating the tear trough is not a trivial procedure. The area is anatomically complex: the skin is thin, vascularized, and prone to edema or irregularities. Even a slight excess of product, a too superficial injection, or an imprecise gesture can lead to visible, sometimes lasting, side effects: Tyndall effect, swelling, asymmetry, or overcorrection.
That is why treatment of this area cannot be improvised. It requires specific medical training, regular practice in infra-orbital injections, and a comprehensive evaluation of the face to avoid treating a hollow in isolation without considering the balance of the midface (cheekbones, orbit, bone structure).
Tear trough filling is a precision procedure. It can only be entrusted to a qualified, experienced physician who is attentive to the natural aesthetics of the face.
In Switzerland, as in most European countries, only certified physicians are authorized to inject hyaluronic acid for aesthetic purposes. This includes so-called ‘aesthetic’ doctors, specialized in non-invasive facial techniques; dermatologists who have received additional training in aesthetic medicine; and plastic surgeons who also perform injections.
However, not all physicians who perform injections treat the tear trough. This is a specific area that requires precise experience. Before choosing a physician, it is therefore essential to verify not only their qualifications but also their actual level of practice in this specific indication.
Several criteria can help estimate a physician’s level of expertise in tear trough treatment :
Certain signs should prompt caution :
In Geneva, the standard of medical excellence is particularly high. Regulations, product traceability, and a culture of natural aesthetics create an ideal framework for safe and elegant treatments.
Physicians in Geneva are accustomed to treating a demanding clientele, often seeking very subtle results. They favor gentle, reversible techniques and use high-end products specifically adapted to the infra-orbital area.
Choosing a physician in this context ensures a precise diagnosis, a perfectly controlled treatment, and thorough follow-up within a medical environment.
An experienced physician does not always say “yes.” Knowing when to indicate a treatment also means knowing when to refuse it. When an under-eye hollow is accentuated by fat pads, very thin skin, or pronounced hyperpigmentation, an injection may not be the most appropriate solution.
A competent physician will identify these situations and propose a suitable alternative — whether it involves Skinboosters, PRP, photorejuvenation, or, in some cases, referral to surgical management. This discernment is a sign of honest medical judgment, not of a routine procedure.
A good physician does not aim to “inject at any cost.” They seek a result that is coherent, safe, and long-lasting. This level of rigor is the foundation of responsible practice.
In the treatment of the tear trough, more is never better. An experienced physician knows that an excess of hyaluronic acid can create irregularities, chronic edema, or a stiff-looking gaze. The current approach, based on subtlety and precision, favors minimal doses injected accurately at the correct depth.
Injecting a small amount, but perfectly, helps avoid overcorrection and achieves a natural result, imperceptible to others. This philosophy relies not only on clinical experience but also on a thorough understanding of orbital anatomy.
In this area, the quality of the technique takes precedence over the quantity of product. It is a high-level aesthetic logic that makes all the difference between an elegant result and an artificial one.
Checking online reviews has become a reflex for many patients. These feedbacks can provide useful indications about the reception, punctuality, or quality of the relationship with the physician. However, they cannot replace a thorough medical evaluation.
A highly competent doctor, but discreet or less active online, may be less visible than a colleague more focused on communication, without this reflecting the real quality of their practice. A positive review, however enthusiastic, does not inform about the technical precision of the procedure, anatomical mastery, or post-procedure care.
Reviews should therefore be considered only as a partial indicator, not as a decisive criterion. It is the quality of the consultation, the clarity of explanations, the relevance of the diagnosis, and the overall seriousness of the physician that should guide a truly informed decision.
With the rise of aesthetic procedures, many low-cost facilities have emerged, promising quick results at very attractive prices. However, when it comes to a delicate area like the tear trough, the choice of the physician should take precedence over any other consideration.
Some high-volume, commercially driven facilities may delegate injections to personnel who are insufficiently trained, inexperienced, or inattentive to the personalized analysis of the face. The use of lower-quality products, poorly suited to the infra-orbital area, can also compromise the result.
A trained, certified physician working in a regulated medical facility and taking the time for proper diagnosis ensures coherent, safe, and lasting care.
An informed patient is a better-protected patient. Before undergoing a treatment, it is legitimate — and even recommended — to ask certain questions. An experienced physician will be able to answer them clearly and without ambiguity.
This type of exchange builds a relationship of trust, and ensures that the treatment will be carried out with seriousness, transparency, and care.
We often talk about technique, anatomy, and safety. But we sometimes forget that the final result also depends on the doctor’s artistic eye. Medical expertise allows for treatment, while a sense of balance allows for enhancement.
An experienced doctor knows that the tear trough should not be filled at all costs. They perceive the surrounding volumes, the natural shape of the face, and the dynamics of the gaze. They adjust not only according to the hollow, but also considering the prominence of the cheekbones, skin tone, and the expression of the eyes at rest as well as in motion.
It is this global vision, both clinical and aesthetic, that distinguishes a simple injection from a truly personalized medical procedure. And this is what the most demanding patients seek: a result that respects their face, without ever freezing it.
Article written by Dr Romano Valeria
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