The treatment of the tear trough with hyaluronic acid injection is one of the most requested aesthetic medical procedures. Discreet, quick, and minimally invasive, this intervention is often chosen for its ability to immediately transform the eyes. But in clinical reality, are the results truly visible as soon as the patient leaves the office ? Should one expect an immediate effect or a progressive evolution ? A careful physician takes the time to explain to each patient that, while the effects may be noticeable quickly, the final result develops progressively, influenced by the product’s integration, the tissue response, and the anatomical specificities of each patient.
The treatment consists of injecting a very specific hyaluronic acid, designed for the infraorbital area. It is chosen for its low hydrophilicity, good tissue integration, and fluidity adapted to this delicate zone.
The procedure takes place in a medical office. The product is injected using a blunt cannula or a very fine needle, depending on the patient’s morphology and the physician’s preference. The meticulous and precise technique aims to restore lost volume without weighing down or freezing the expression.
The session lasts about ten minutes on average. No bandage or social downtime is required, reinforcing the idea of a quick treatment with immediate results.
Immediately after the treatment, improvement is visible in the majority of cases. The hollow is subtly filled, the transition between the lower eyelid and the cheek is softened, and the eyes appear more rested.
However, it is important to note that this immediate correction can be partially masked by temporary, perfectly normal phenomena, such as slight localized swelling, redness, a minor bruise, or temporary asymmetry due to tissue tension.
These mild side effects generally disappear within a few days. Patients should therefore be informed that the immediate result does not necessarily reflect the final outcome.
Hyaluronic acid takes several days to stabilize within the tissues. During this phase, the product attracts water, integrates with the surrounding structures, and gradually conforms to the local anatomy. It is this slow and natural integration process that allows for a harmonious, undetectable, and long-lasting result.
In general, improvement is visible by the 3rd or 4th day, the product stabilizes within the tissues in 10–15 days, and the result is considered final after 4 weeks.
A touch-up is not always necessary. A well-executed filler treatment during the first session can be sufficient to achieve a satisfactory result, especially when the volume to be restored is moderate. However, in a cautious and reasoned medical approach, it is often preferable to adopt a progressive strategy: slightly under-correct during the first injection, reassess the result after a few weeks once any potential swelling has resolved, and adjust if necessary with a second injection.
This two-step method helps avoid overcorrection, respects the natural evolution of the face, and ensures a harmonious and discreet result. It fully aligns with a precision aesthetic strategy, meeting the expectations of patients seeking natural, safe, and long-lasting results.
The time to achieve the final result can vary depending on several parameters :
A thorough preliminary evaluation allows the protocol to be personalized, manages patient expectations, and ensures a safe aesthetic outcome.
In the treatment of the tear trough, it is essential to prioritize accuracy and subtlety of the result rather than the immediate satisfaction of a visible effect right after the session. In this mobile and expressive anatomical area, any excess product must be avoided. Injecting too much hyaluronic acid, or more generally performing an injection poorly, can disrupt the harmony of the eyes, causing swelling, rigidity of features, or a frozen appearance, contrary to the desired natural aesthetic.
The goal is not to completely fill the hollow, but to reduce the under-eye shadow and respect the eye’s natural dynamics.
For this, a perfectly mastered injection technique is indispensable, but it must be accompanied by clear patient information about the time needed for product integration and the limits of immediate correction.
A result that is both natural and harmonious relies on the precision of the procedure, respect for physiological volumes, and careful management of expectations—both visually and emotionally.
In some cases, the final result of a tear trough injection is not immediately apparent. Several factors can delay its appearance, without calling into question the quality of the medical procedure.
In all cases, the physician must adapt their technique to these specificities : choice of product, injection depth, and injected volume. It is also essential to clearly inform the patient that assessing the final result may take several weeks, and that a possible additional injection should only be considered after this integration period.
It is not uncommon for a patient to feel, in the hours following the injection, that the treated area has excessive volume. This sensation, although common, does not necessarily reflect an actual overcorrection. It can be explained by various transient phenomena related to the natural response of the tissues.
Several factors can contribute to this sensation :
In the vast majority of cases, these effects are temporary and do not justify intervention. It is essential to allow time for the swelling to subside — usually between 48 and 72 hours, sometimes slightly longer in certain patients.
That is why premature aesthetic evaluation is not recommended. The physician’s role is to reassure the patient, monitor clinical progress, and distinguish a temporary reaction from a true overcorrection, the latter remaining exceptional when the injection technique is mastered and the physician experienced.
The period immediately following the injection corresponds to a mild, physiological inflammatory phase, during which the tissues react to the presence of the hyaluronic acid gel. During this time, the appearance of the under-eye hollow may fluctuate temporarily.
The first 48 hours are characterized by slight swelling, often asymmetrical, changes in skin tension, occasional sensitivity to touch, or even a feeling of tightness.
During this phase, the product is not yet fully integrated. In the days following the injection, the hyaluronic acid begins to distribute within the tissues but has not yet reached optimal integration. This integration phase is gradual and can be influenced by local vascularization, particularly in the presence of a small bruise that may temporarily alter the uniformity of the result.
For this reason, it is essential not to prematurely interpret the aesthetic result. Even if improvement is visible within the first few hours, the final outcome can only be assessed once the inflammation has resolved and the product is fully integrated.
Once the final result is stabilized, the effect of a hyaluronic acid injection in the tear trough typically lasts between 12 and 18 months. This duration depends on several factors: the type of product used, the patient’s metabolism, and the quality and thickness of the skin in the treated area.
In some patients, the effects of the correction can last beyond two years, particularly when the treatment has been carefully planned and performed, and the skin is regularly maintained with complementary care: targeted cosmeceuticals, maintenance mesotherapy sessions, daily photoprotection, etc.
The longevity of the result is also influenced by the natural aging of the face. Over time, changes such as skin laxity, infra-orbital bone loss, or the appearance of new hollows can alter the initial balance. Hence the importance of regular medical follow-up to adjust the aesthetic strategy if necessary, progressively and always respecting the morphology of each patient.
Article written by Dr Romano Valeria
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