What is the valley of tears?

This poetic expression (it designates the place where tears flow) refers to the line between the cheekbone and the wing of the nose, which continues the rim of the eye. In fact, it's the same line that, in its orbital part (upper part), forms the ring and, in its malar part (lower part at the level of the cheekbone), forms the valley of tears. Its appearance gives a sad, tired look and makes the eyes droop. A shadowy area (a hollow always corresponds to a shadowy area) is created in the middle third of the face, which becomes less luminous. Its appearance is accompanied by a break in the curve of the cheekbone, the appearance of the nasolabial fold and sometimes bitterness folds and jowls.


In aesthetic medicine, the treatment of the valley of tears is increasingly in demand by people wishing to regain a youthful, rested appearance.
The hyaluronic acid injections in the valley of tears are an effective, safe solution for fighting the signs of ageing and restoring a radiant, rested appearance.

Patients particularly appreciate the immediate results and rapid recovery. Visit before and after photos treatment clearly illustrate the significant improvement in appearance, which contributes to the growing popularity of this procedure in aesthetic medicine.

Valley of tears: the causes

The appearance of the valley of tears is due to ageing, in particular to changes in the malar fat. Over time, the deep malar fat melts and the superficial malar fat falls away. This creates a void that corresponds to the valley of tears.

The appearance of the valley of tears is mainly the result of age-related physiological processes. From the age of 25, the body's secretion of collagen decreases. This substance plays a vital role in the skin and its tissues. Sometimes referred to as the "anti-ageing protein", collagen gives skin tissue support, suppleness and elasticity. The presence of collagen improves skin texture, making it smooth and firm, two visible signs of youth. Reduced collagen production leads to a deterioration in skin quality, with a loss of elasticity. The facial area tends to sag.


Stages of severity of the valley of tears

The valley of tears caused by sagging facial fat or melting cheek fat worsens over time.

There are 9 different stages in the melting of malar fat.
Three stages of severity have been identified for digging:

  • Stage 1: loss of volume limited medial to the valley of tears.
  • Stage 2: significant lateral orbital volume loss in addition to medial orbital volume loss.
  • Stage 3: circumferential depression along the orbital rim medially and laterally.

In the mild stage, the valley of tears may appear as a slight shadow under the eyes, often only noticeable when tired or sleep-deprived.
In the moderate stage, this depression becomes more visible, responsible for more pronounced hollows and a permanently tired appearance, even at rest.
In the severe stage, the valley of tears is deeply marked, with significant hollows giving the face an aged, emaciated appearance.

How can the valley of tears be treated without surgery?

The valley of tears is treated with an injection of hyaluronic acid.
There are two techniques: filling the hollow and lifting the malar fat.

Sometimes the injection of dark circles and cheekbones, according to the patient's needs and wishes.

The nasolabial folds and folds of bitterness are improved by the lift technique, but an additional injection in these areas (if necessary) can be carried out during the same session.

By filling in the tear trough with an injection of hyaluronic acid, it is possible to reduce shadows under the eyes and restore the curve of the cheekbone, giving a fresher, younger-looking face.

→ Find out more about lift technique

How do you remove the valley of tears? The medical lift

This technique, invented by Brazilian visual artist Mauricio de Maio, is one of the variations of the MD Codes.
The hyaluronic acid used is very firm, with lifting properties, and placed deep against the bone. The points injected need to be adapted to each face, which is why it is so important to work with an experienced practitioner.

The lift technique and the Filling the valley of tears by injection of hyaluronic acid can be combined, but I always precede the lift technique with that of filling the hollow. This is essential in order to avoid puffing up the face and to give an attractive, natural result.

→ Find out more about hyaluronic acid injections

How can the valley of tears be filled with an injection of hyaluronic acid?

A cannula is used to fill the hollow of the valley of tears; injecting with a needle is dangerous.
The hyaluronic acid must be placed deep against the bone and have very low hydrophilicity, both of which are essential to avoid the appearance of permanent oedema typical of a botched injection.

Which hyaluronic acid for the valley of tears?

  • If the face is thinning and tending to become skeletal: a highly cross-linked hyaluronic acid such as Emervel Volume, Restylane or Restylane lyft is injected into the triangle of the valley of tears. The injection is deep, in contact with the bone.
  • If the face looks heavy, slack and shows a ptosisRestylane lyft: the aim is to pull on the sagging fat, in which case the doctor performs a medical facelift using injections of very dense hyaluronic acid such as Restylane lyft.

Results and follow-up

The results of hyaluronic acid injections in the valley of tears are generally immediate, with a visible improvement from the very first session. Patients notice a noticeable reduction in hollows, giving the face a more rested and rejuvenated appearance. The skin appears smoother and more hydrated, with volume restored in a natural way.

The middle and lower third of the face are lifted: the nasolabial folds, bitterness folds and jowls are improved. It is not simply a question of filling a hollow but of a facial rejuvenation treatment and look.

The after-effects of the procedure are minimal, with mild and temporary side-effects such as slight redness, swelling or bruising, which generally disappear within a few days. Patients can resume their usual activities immediately after the session.

Results last between six and twelve months, depending on individual characteristics and the product used, and periodic touch-ups can prolong the effect.

Valley of tears injection: prices

A procedure to fill the tear valley may require several syringes of hyaluronic acid. The price therefore depends on the number of syringes injected. This varies according to various criteria: the stage of development of the phenomenon, the characteristics of the face and its anatomy. During the initial consultation, the doctor will determine the most appropriate protocol for effective treatment of the valley of tears.

Type de consultation Tarifs généralement pratiqués
Hyaluronic acid
CHF 600 per syringe


Treating the valley of tears helps to reduce dark circles, fill hollows and restore a rested, rejuvenated appearance to the face. It also improves the texture and hydration of the skin in this area.

Yes, the results of filling injections with hyaluronic acid are immediate. You'll notice a visible improvement from the very first session.

The treatment is rapid, usually taking five minutes. You can resume your daily activities immediately afterwards.

The results of hyaluronic acid injections can last between six and twelve months, depending on skin type, lifestyle and the product used. Periodic touch-ups can prolong the effects.

To naturally reduce the appearance of the tear trough, adopt a skincare routine that includes moisturising and using creams containing ingredients such as vitamin C, retinol and hyaluronic acid. Gentle under-eye massages can also stimulate circulation and reduce the appearance of hollows.

As with any medical procedure, valley of tears injections carry certain risks. These may include allergic reactions, infections, bruising, swelling or asymmetry. It is essential to consult a qualified professional to avoid these risks and ensure an optimal result.

The valley of tears occupies the lower part of the hollow between the cheekbones and the sides of the nose. The dark circles occupy the upper part of this hollow.

Hyaluronic acid injections fill hollows by restoring lost volume and hydrating the skin. Hyaluronic acid is a substance that occurs naturally in the body, making it safe and effective for this use.

The treatment is generally painless, thanks to the use of very fine needles and anaesthetic products. Patients feel at most a slight discomfort during the procedure.

Side effects are rare and minor, including slight redness, swelling or bruising around the treated area. These usually disappear within a few days.

The Valley of Tears treatment is suitable for anyone wishing to reduce the hollows that have formed with age and regain a rested appearance. A personalised consultation will determine whether you are a good candidate.

To apply make-up to the valley of tears, start by applying a moisturising make-up base. Then use a creamy concealer, slightly lighter than your natural skin tone, to fill in the depression. Blend gently with a sponge or brush for a natural finish. Finish with a thin layer of translucent powder to set the make-up and prevent creasing. The results of Sculptra are visible in just a few months.

Reviews of tear valley injections are generally positive. Patients appreciate the immediate results and the significant improvement in their appearance. The procedure is often described as quick and painless, with minimal side effects.

Other areas to be treated

Hollow eye

Opening Look

Dark circles