The valley of tears is a particularly sensitive area of the face, where signs of fatigue and skin laxity sometimes appear early. The injection of hyaluronic acid in this region aims to correct an unsightly hollow located between the inner corner of the eye and the cheekbone, giving the face a rested and younger appearance. But beyond the technique, what patients are legitimately interested in are the results: what can be expected concretely before and after the injection ? When does one observe a change ? What is the real progression in the days and weeks that follow ?
This page provides an objective overview of the before/after results of a hyaluronic acid injection in the valley of tears, based on current medical data.
Before any injection, a thorough medical examination is conducted to analyze the valley of tears in a personalized manner. This area may present a more or less pronounced hollow depending on several factors: age, skin quality and thickness, genetics, and volume loss due to local fat atrophy.
The reasons for consultation are varied: tired-looking eyes, persistent shadows under the eyes, sad expression, asymmetry between the two sides of the face.
At this stage, the exchange between the doctor and the patient plays a central role. It allows for precisely understanding aesthetic expectations and setting a realistic goal: reduce the hollow, soften the shadow, and harmonize the transition between the lower eyelid and the cheek. This thorough evaluation also determines whether a localized correction of the valley of tears is sufficient, or if a more comprehensive approach is preferable, including, for example, treatment of the cheekbones or dark circles.
The result is visible immediately after the injection, as soon as the patient leaves the clinic. The hollow is reduced, the valley of tears appears filled, and the eyes look more open and brighter. The transformation is often subtle but noticeable, especially when the treatment is well performed with a suitable product.
However, the result observed immediately after the injection is not yet final. Slight swelling may appear in the hours that follow, giving the impression of a greater filling than will actually be the case. It is therefore necessary to wait a few days for the product to stabilize and for the final result to be properly appreciated.
During the first 24 to 72 hours, some patients may experience moderate swelling, slight redness or tenderness to the touch, and sometimes localized bruising.
These effects are temporary and do not affect the final result. They fade spontaneously within a few days, without the need for social avoidance.
From the 7th day, the result of the injection reaches a noticeable stage of stability. The hyaluronic acid gradually integrates into the tissues, and the filling effect improves. The initial hollow is smoothed, the under-eye shadow is reduced, and the eyes look rested.
It is also at this stage that any residual asymmetry can be identified. If necessary, a minor touch-up is performed, most often starting from the second week.
The result becomes clearly more natural, without any overfilled effect or skin tension. The eyes look rested, without the face appearing altered.
The final result is generally assessed 3 to 4 weeks after the injection. This is when tissue integration is optimal, and the disappearance of swelling allows for an accurate evaluation of the aesthetic result.
The expected outcome is characterized by a harmonious transition between the lower eyelid and the cheek, with a smooth contour, no visible irregularities or hollows, and eyes that appear noticeably brighter, free from the deep shadows typically associated with hollow under-eyes. The result is natural, without facial stiffness or alteration of expression.
When properly indicated and precisely performed, this correction provides a true aesthetic benefit: the eyes look rested, more open, subtly refreshed. Those around the patient notice an improvement without necessarily suspecting an aesthetic procedure — a discreet, balanced result, in line with the expectations of the majority of patients.
The durability of the result depends on several factors :
On average, the result lasts between 9 and 15 months. Some patients notice a faster disappearance (6 to 8 months), while others benefit from a prolonged effect.
A new session can be considered as soon as the hollow reappears. However, reinjecting too early is not recommended: the goal is to respect the natural resorption cycle of the product and maintain aesthetic consistency over time.
A good result is primarily based on a subtle balance. It is not simply about filling a hollow, but about recreating a natural harmony between the lower eyelid, the eyes, and the cheekbone.
The criteria for a successful result are as follows :
• Natural : the face should not reveal that an injection has been performed.
• Symmetrical : the balance between the two sides of the face must be respected.
• Gradual : the outcome should follow an aesthetic continuity, without a frozen effect or abrupt transformation.
• Stable : there should be no product migration, irregularities, or visible reactions.
It is up to the doctor to accurately assess the amount of product to be injected, to select a hyaluronic acid formulation suitable for the fineness of the tissues, and to master a safe injection technique, often performed with a micro-cannula or at a deep point, depending on the patient’s anatomy.
Before/after photos are often requested by patients. They allow the evolution to be visualized, the result to be objectively compared, and discussed with the doctor. However, they must be used with caution.
Each face is unique, and no result can be exactly reproduced. Photos published on the internet or social networks reflect specific cases, subject to particular lighting, angle, and expression conditions.
In consultation, a serious doctor uses before/after photos as a clinical follow-up tool, not as a promise of results. In Geneva, high-end medical establishments favor an approach based on analysis, personalization, and respect for naturalness.
One of the primary objectives of an aesthetic consultation is to determine whether the improvement expected by the patient can reasonably be achieved. In the case of a hyaluronic acid injection in the valley of tears, the doctor has extensive clinical experience, an eye trained in morphological analysis, and tools to predict a certain type of result. However, it is essential to remember that any treatment remains a procedure subject to biological variability.
The final outcome depends notably on tissue quality, the degree of initial hollowing, skin tone, as well as the patient’s metabolism, which influences the speed of product integration and resorption. Thus, although the procedure is standardized in its technique, the result may slightly vary from one patient to another. That is why the doctor does not simply “promise a result,” but guides the patient in a realistic understanding of the expected outcome.
Anticipation is therefore based on a careful but always nuanced evaluation: it relies on experience, scientific data, and a detailed reading of the facial anatomy. A successful injection is one that respects this variability while providing a clear, visible improvement that is consistent with the face.
The injection in the valley of tears is often perceived by patients as a simple and immediate solution to erase signs of fatigue. However, the doctor’s role is precisely to distinguish what is aesthetically desirable from what is medically reasonable.
Some patients imagine a complete erasure of the hollow or dark circles, whereas the treatment primarily aims for a harmonious attenuation of the hollow, without excessive correction. This nuance is essential: the success of an injection in this area does not lie in the complete disappearance of an imperfection, but in the subtle improvement of a tired-looking gaze, while preserving the natural expression of the face.
This preparatory educational work helps to avoid disappointment. When expectations are clearly identified, patients understand that the goal is not to “transform” the face, but to restore coherence, freshness, and balance. In this context, satisfaction comes as much from the visible result as from the feeling of being in harmony with one’s image.
Sometimes a patient, a few days after an injection, does not immediately perceive the benefits of the treatment. This reaction is not uncommon, especially when the result is deliberately subtle, for the sake of naturalness. The perception of change is often influenced by the way one looks at oneself, sometimes more critically than those around them.
That is why objective comparison, notably through before/after photographs taken during consultation, plays a determining role. It allows the face before treatment to be visualized, the hollow to be softened, the shadow reduced, and the gaze harmonized. This concrete visual feedback helps anchor the reality of the result in the patient’s mind.
Furthermore, the improvement felt is not limited to the aesthetic aspect. It often extends to psychological comfort: the patient feels less tired, more confident, better represented by their image. The perceived result is therefore an integral component of the outcome, just as much as the measurable visual aspect.
Even though complications are rare when a treatment is performed by an experienced doctor, it remains essential to inform the patient about what can, in some cases, indicate an inappropriate result.
Among the signs to watch for are an obviously excessive correction, giving the area a bulging or swollen appearance, persistent asymmetry not related to a natural variation of the face (all faces are asymmetrical), or a palpable irregularity to the touch. Other elements, such as swelling that does not subside after several days, or the appearance of a bluish reflection under the skin (Tyndall effect), may indicate that the product was placed too superficially.
These situations should not cause undue concern, but they require careful medical supervision. An experienced doctor will quickly identify the nature of the problem and, if necessary, propose an adjustment or correction (for example, using hyaluronidase in cases of excessive correction or poor product integration).
Article written by Dr Romano Valeria
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