The eyes are among the first areas of the face to reveal signs of fatigue or skin laxity. The tear trough, an anatomical hollow located between the inner corner of the eye and the cheekbone, gradually becomes more pronounced with age. Tear trough correction with hyaluronic acid is a targeted and effective response to this common concern.
But how does this technique actually work ? On which mechanisms is its effectiveness based ? What is the medical rationale behind this treatment ? This page provides clear and detailed explanations.
The tear trough corresponds to a natural groove that begins at the inner corner of the eye and extends slightly diagonally toward the cheek. In some individuals, it is present from a very young age. In others, it develops progressively over time.
The hollowing is caused by several factors :
The result is a permanent shadow under the eye, giving the gaze a sad or tired appearance, even when the person is in good health. It is precisely this hollow that hyaluronic acid aims to correct.
Tear trough correction is based on a simple principle : restoring lost volume by injecting a small amount of hyaluronic acid into the hollow, a substance naturally present in the human body.
The hyaluronic acid used is a viscoelastic gel, specifically formulated for this delicate area of the face. Its role is to gently fill the depression, smooth the transition between the eye and the cheek, and reduce the shadow caused by the tear trough.
Unlike other areas of the face, the goal here is not to add volume, but rather to softly rebalance with a light, discreet, and natural correction.
The injection is performed in the clinic following a medical consultation. The physician carefully assesses the facial anatomy, the depth of the hollow, the skin quality, and the possible presence of dark circles, asymmetries, or under-eye bags.
The injection itself takes between 15 and 30 minutes. It can be performed either with a very fine needle or a micro-cannula, depending on the physician’s technique and the specific characteristics of the area being treated. The goal is to deposit the product deeply, at the bone level or in contact with the ligaments, with great precision, to avoid excess and achieve a natural result. The injected volume is always small and applied in tiny amounts to respect the natural expression of the eyes.
The procedure is generally minimally painful, does not require special anesthesia, and does not cause social downtime. In some cases, slight swelling or minor bruising may occur, but these side effects are temporary and disappear within a few days.
Le choix du produit injecté joue un rôle essentiel. La vallée des larmes est une zone particulièrement délicate : la peau est fine, très vascularisée, et sensible aux variations d’hydratation comme à la pression. L’acide hyaluronique utilisé doit donc répondre à des critères très précis. Il doit être peu réticulé pour s’intégrer en douceur dans les tissus, peu hydrophile pour éviter tout gonflement ou reflet bleuté (appelé effet Tyndall), et suffisamment malléable pour offrir un résultat homogène, sans irrégularités. À cela s’ajoute bien sûr l’exigence de sécurité, avec des produits traçables, certifiés et conformes aux normes suisses.
Certains gels ont été spécifiquement formulés pour le traitement de la région infra-orbitaire et offrent un bon compromis entre finesse, tolérance et tenue dans le temps.
L’acide hyaluronique s’impose aujourd’hui comme le produit de référence pour le traitement de la vallée des larmes, et ce pour plusieurs raisons évidentes. Naturellement présent dans l’organisme – notamment au niveau cutané –, il joue un rôle clé dans l’hydratation et la structuration des tissus. Utilisé en injection, il permet de restaurer subtilement les volumes perdus sans alourdir ni figer les expressions.
Au niveau de la vallée des larmes, l’objectif n’est pas de « remplir », mais bien de recréer une transition douce et naturelle entre la paupière inférieure et la joue. L’acide hyaluronique s’y prête idéalement grâce à sa souplesse, sa capacité de modulation et la possibilité de l’utiliser en quantités très précises.
Autre atout majeur : son caractère réversible. En cas de résultat insatisfaisant, le produit est résorbable. Ces qualités expliquent pourquoi ce produit, lorsqu’il est utilisé avec précision et discernement, est devenu un outil incontournable dans la prise en charge esthétique de cette région du visage.
Hyaluronic acid injection in the tear trough provides excellent results when the indication is properly established. It helps reduce a visible hollow, often responsible for a sad or tired appearance, even in patients who are not actually fatigued. By restoring slight support under the lower eyelid, the eyes gain softness and brightness. The goal is not to transform the face, but to restore balance by correcting this small collapse between the eye and the cheekbone.It is also important to understand what this treatment does not do. It does not treat fat pads, which usually require a surgical approach. It also does not correct pigmented or vascular dark circles, nor skin laxity. In these cases, a combined protocol is often necessary, for example including skin care, lasers, or other techniques.
The term “filling” is often used, but it can be misleading. In the case of the tear trough, the goal is not to swell or fill an area as one would do for a cheek or a nasolabial fold. What is primarily being corrected is a shadow. This facial area is marked by a break in light: the hollow creates a dark line that immediately gives a tired appearance, even if the lost volume is sometimes minimal. The visual effect is far more significant than the actual depth of the hollow. The role of hyaluronic acid is therefore to soften this transition, to “break the shadow” without altering apparent volumes. The aim is not to transform features, but to blur a discontinuity. It is this work with light, rather than substance, that restores radiance and freshness to the eyes. This also explains why this area requires such technical skill and experience: one must neither overcorrect nor inject into the wrong plane, as this could result in an unnatural outcome.
One might think that a good product alone is enough to guarantee a successful result. However, in the treatment of the tear trough, success relies primarily on mastery of the injection technique. This is an anatomically complex area: shallow, narrow, and traversed by numerous blood vessels and nerves. An injection that is too superficial or poorly performed can cause unsightly swelling, irregularities, or even a persistent bluish effect. The physician must therefore adapt the technique for each patient: choice of needle or cannula, injection plane depth, and the quantity injected. In most cases, small doses are carefully distributed to allow the product to blend naturally into the tissues. This gradual, tailor-made approach is often the key to a more open and luminous gaze. The physician’s experience is recognized in their ability to dose accurately, observe carefully, and respect the natural dynamics of the face.
Article written by Dr Romano Valeria
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