{"id":27636,"date":"2025-06-10T09:35:38","date_gmt":"2025-06-10T07:35:38","guid":{"rendered":"https:\/\/drromanovaleria.ch\/?post_type=infographie&#038;p=27636"},"modified":"2026-07-03T13:46:50","modified_gmt":"2026-07-03T11:46:50","slug":"causes-appearance-tear-trough","status":"publish","type":"infographie","link":"https:\/\/drromanovaleria.ch\/en\/infographie\/causes-apparition-vallee-larmes\/","title":{"rendered":"Quelles sont les causes principales de l\u2019apparition de la vall\u00e9e des larmes ?"},"content":{"rendered":"<h1>WHAT ARE THE MAIN CAUSES OF THE APPEARANCE OF THE TEAR TROUGH ?<\/h1>\n<p class=\"translation-block\">The \u201c<a href=\"https:\/\/drromanovaleria.ch\/en\/needs\/look\/tear-trough\/\">tear trough<\/a>\u201d gives the eyes a tired, sad, or aged appearance. This anatomical area, also called the nasolacrimal groove, is particularly delicate because it lies at the junction of multiple muscular, fatty, and bony structures. Its progressive alteration is a common concern, especially in Geneva, where a demanding clientele seeks targeted, effective, and harmonious facial treatments. Understanding the precise causes of the tear trough\u2019s appearance is essential to offer suitable treatments and achieve natural, long-lasting results.<\/p>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"220\" src=\"https:\/\/drromanovaleria.ch\/wp-content\/uploads\/2024\/05\/hydratation-peau.webp\" alt=\"image of young hydrated skin\" srcset=\"https:\/\/drromanovaleria.ch\/wp-content\/uploads\/2024\/05\/hydratation-peau.webp 300w, https:\/\/drromanovaleria.ch\/wp-content\/uploads\/2024\/05\/hydratation-peau-16x12.webp 16w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><br \/>\n\t\t\t\t\t<a href=\"https:\/\/drromanovaleria.ch\/en\/contact-doctor-romano-valeria\/\"><br \/>\n\t\t\t\t\t\t\t\t\tBook an appointment<br \/>\n\t\t\t\t\t<\/a><\/p>\n<h2>\n\t\t\t\tContents\t\t\t<\/h2>\n<p>\t\t\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" viewbox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M207.029 381.476L12.686 187.132c-9.373-9.373-9.373-24.569 0-33.941l22.667-22.667c9.357-9.357 24.522-9.375 33.901-.04L224 284.505l154.745-154.021c9.379-9.335 24.544-9.317 33.901.04l22.667 22.667c9.373 9.373 9.373 24.569 0 33.941L240.971 381.476c-9.373 9.372-24.569 9.372-33.942 0z\"><\/path><\/svg><br \/>\n\t\t\t\t<svg aria-hidden=\"true\" viewbox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M240.971 130.524l194.343 194.343c9.373 9.373 9.373 24.569 0 33.941l-22.667 22.667c-9.357 9.357-24.522 9.375-33.901.04L224 227.495 69.255 381.516c-9.379 9.335-24.544 9.317-33.901-.04l-22.667-22.667c-9.373-9.373-9.373-24.569 0-33.941L207.03 130.525c9.372-9.373 24.568-9.373 33.941-.001z\"><\/path><\/svg><br \/>\n\t\t\t\t<svg aria-hidden=\"true\" viewbox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M500 975V858C696 858 858 696 858 500S696 142 500 142 142 304 142 500H25C25 237 238 25 500 25S975 237 975 500 763 975 500 975Z\"><\/path><\/svg>\t\t\t<\/p>\n<h2>Ageing : the main cause of tear trough development<\/h2>\n<p class=\"translation-block\">With age, the gradual loss of the deep fat compartments of the face is one of the main causes of the appearance of the tear trough. More specifically, the malar fat \u2014 located in the cheek area \u2014 decreases and migrates, leading to a loss of suborbital support. This fat loss is often accompanied by ptosis (sagging) of the tissues, accentuating the hollow between the orbit and the cheek. The loss of volume is not limited to superficial tissues : the deeper areas are also affected, altering the overall architecture of the face.<br>Bone aging also contributes to the formation of the tear trough. 3D imaging studies have shown that the malar bone (the cheekbone) gradually resorbs with age, particularly in its medial portion. This resorption reduces the structural support of the soft tissues, causing them to sag downward and accentuating the under-eye hollows. This phenomenon, often subtle but progressive, contributes over time to the perception of a tired look.<\/p>\n<h2>Genetic and morphological causes of tear troughs<\/h2>\n<ul>\n<li>Individual anatomical constitution\u00a0: some people have visible tear troughs from a very young age. This constitutional feature is often associated with naturally low cheekbones, a hollow lower eyelid or a pronounced lid-cheek junction. In these cases, tear troughs have an anatomical origin rather than being caused by ageing, although they may deepen over time. Medical diagnosis distinguishes congenital causes from acquired changes and allows treatment to be adapted accordingly.<\/li>\n<li class=\"translation-block\">Heredity : a genetic predisposition to early skeletonisation of the eye area can be inherited independently of chronological age or lifestyle. This hereditary component is particularly evident in patients from ethnic or phenotypic groups with slender facial features.<br>Including this history in clinical assessment is essential when developing a personalised treatment protocol.<\/li>\n<\/ul>\n<h2>Collagen loss and skin ageing : why tear troughs deepen<\/h2>\n<ul>\n<li>Intrinsic skin ageing\u00a0: skin quality plays a fundamental role. With age, skin gradually loses elasticity and thickness as collagen, elastin and hyaluronic acid production slows. This skin atrophy makes underlying structures (bones, muscles and ligaments) more visible and accentuates hollows. Thinning of the infraorbital skin intensifies natural shadows, contributing to formation of the groove.<\/li>\n<li>Extrinsic skin ageing\u00a0: environmental factors \u2014 particularly chronic sun exposure (photoageing), smoking, pollution, oxidative stress and an unhealthy lifestyle \u2014 also contribute to dermal deterioration. These stressors accelerate loss of skin firmness, reduce local microcirculation and weaken dermal structure, worsening hollows around the eyes.<\/li>\n<\/ul>\n<h2>Ligament and muscle laxity : a cause of tear troughs<\/h2>\n<ul>\n<li>Orbital and malar ligaments\u00a0: the face is supported by a complex ligament network that stabilises soft tissues. Over time, these ligaments \u2014 particularly the orbital and zygomatic ligaments \u2014 lose tension and allow tissues to sag. Ligament laxity is particularly visible in the infraorbital area, encouraging folds and hollows in the tear trough.<\/li>\n<li>Reduced muscle tone\u00a0: the orbicularis oculi muscle surrounding the eye can also lose tone with age. This muscle laxity causes an uneven redistribution of volume and may extend the tear trough towards the cheek. It is often accompanied by compensatory muscle overactivity, creating excessive contractions and encouraging static and dynamic wrinkles around the eye.<\/li>\n<\/ul>\n<h2>Weight loss, lifestyle and tear trough development<\/h2>\n<ul>\n<li>Significant weight changes : substantial weight loss or gain directly affects facial fat volume. Yo-yo dieting or rapid fat loss associated with certain conditions or drug treatments can deepen infraorbital hollows. The face, particularly its middle third, is sensitive to these changes, which can accelerate tear trough development even in younger patients.<\/li>\n<li>Lifestyle habits : lack of sleep, an unbalanced diet, chronic dehydration and stress can all make the eyes look more tired. Although not directly responsible for tear trough development, they may worsen its clinical appearance or bring it forward. Comprehensive care combining aesthetic medical procedures with healthier lifestyle habits is therefore essential for a lasting, harmonious result.<\/li>\n<\/ul>\n<h2>Medical and traumatic causes of tear troughs<\/h2>\n<ul>\n<li>After-effects of surgery or trauma\u00a0: certain operations (lower blepharoplasty, rhinoplasty or malar lifting) or facial injuries can cause retraction or secondary hollowing in the tear trough. Poor healing, excessive fat resorption or postoperative fibrosis may alter the natural volumes of the lid-cheek area.<\/li>\n<li>Underlying conditions : endocrine disorders, severe nutritional deficiencies (particularly protein, iron or vitamin deficiencies) or chronic skin conditions may indirectly affect skin firmness and facial volume balance. In these cases, tear troughs are just one of many signs of a wider imbalance.<\/li>\n<\/ul>\n<h2>How does facial anatomy contribute to tear trough formation ?<\/h2>\n<p class=\"translation-block\">The infraorbital region is a particularly complex anatomical area, where several tissue layers with distinct functions and characteristics overlap : the epidermis, dermis, orbicularis muscle, superficial and deep fat pads, supporting ligaments, as well as the zygomatic bone and orbital rim. This multilayered, thin, and dense organization is designed to allow both high mobility and expressiveness of the eyes.<br>Over time, the different tissue layers lose their functional cohesion. The network of fibrous septa anchoring the superficial fat to the deep fat becomes looser, causing migration and loss of fat volumes. At the same time, the skin thins, making the underlying anatomical discontinuities more visible. This micro-anatomical disruption creates a clear demarcation between the periocular area and the cheek, accentuating the hollow that forms the tear trough.<br>This insidious and progressive process explains why the tear trough can appear from the thirties, even in the absence of pathology or fatigue. It also highlights the importance of considering each tissue plane when performing an aesthetic analysis of the midface.<\/p>\n<h2>Does orbicularis oculi muscle overactivity contribute to tear troughs ?<\/h2>\n<p class=\"translation-block\">The orbicularis oculi muscle, a ring-shaped muscle surrounding the eyelid, plays an essential role in eyelid closure and the expressiveness of the gaze. Its contraction is constantly engaged, either reflexively (blinking) or voluntarily (facial expressions). In some patients, this muscle activity is excessive.<br>Hyperactivity of the orbicularis muscle exerts chronic traction on the underlying tissues. Over time, this mechanical action contributes to the wear of ligamentous attachments and compression of superficial fat, promoting its atrophy. The orbicularis muscle, through repeated contraction, also creates a \u201cpleated\u201d effect on the skin, accentuating the appearance of the tear trough.<br>This functional factor is particularly important because it is often present from a young age, contributing to the early appearance of the valley of tears in young patients. It also explains why some patients, despite good skin quality, exhibit a prematurely hollowed gaze.<\/p>\n<h2>Lymphatic drainage and circulation : their role in tear trough development<\/h2>\n<p class=\"translation-block\">The lymphatic system plays a key role in removing cellular waste and maintaining tissue fluid balance. However, the infraorbital area has a poorly developed lymphatic network and relatively slow vascular circulation. This anatomical characteristic makes it susceptible to stagnation, particularly with tiredness, stress or prolonged lying down.<br>Insufficient lymphatic drainage may cause swelling \u2014 often slight, but enough to accentuate natural shadows around the eyes. This congestion makes the eyes look tired and heavy while visually emphasising the lacrimal hollow. Although secondary, this cause acts as an aggravating factor, making tear troughs more apparent, particularly on waking or in patients prone to water retention.<br>Vascular congestion may also influence perception of the infraorbital hollow. Venous stasis, particularly in the under-eye plexuses, can darken the area, emphasising the groove's depth through contrast. This mechanism is often temporary but may become chronic if its causes are not identified and corrected.<\/p>\n<h2>Do hormonal factors contribute to tear trough development ?<\/h2>\n<p class=\"translation-block\">Hormones play a crucial role in tissue regeneration, collagen production, and water retention in cutaneous and subcutaneous tissues. Among them, estrogens have a direct effect on skin hydration, dermal thickness, and the density of supporting fibers. In women, the abrupt drop in estrogen during menopause leads to a rapid deterioration of skin tone and tissue firmness, including in the infraorbital region.<br>More generally, hormonal aging \u2014 whether related to age or certain endocrine pathologies \u2014 causes a reduction in hyaluronic acid synthesis, loss of dermal elasticity, and decreased vascularization. These factors reduce the natural turgor of tissues, making underlying structures more visible. In men, the gradual decline of androgens can also lead to decreased bone and muscle density, contributing to laxity of facial support.<br>This hormonal factor is often underestimated, yet it represents a major systemic cause in the acceleration of facial aging. It must be considered in the overall facial assessment, particularly in premenopausal women or patients showing signs of endocrine disturbances.<\/p>\n<h2>Pollution, sun and smoking : factors that worsen tear troughs<\/h2>\n<p class=\"translation-block\">Skin ageing and signs such as tear troughs are strongly influenced by the living environment. Among the most damaging extrinsic factors are chronic exposure to ultraviolet radiation, urban pollution, smoking and blue light from digital screens. These often unnoticed stressors cause cellular oxidative stress that gradually damages collagen fibres, weakens cell membranes and reduces elastin production.<br>The skin around the eyes, naturally thinner than elsewhere on the face, is particularly vulnerable to these attacks. It ages faster, with reduced dermal density and deeper hollows such as tear troughs. Air pollution has also been identified as an aggravating factor in periorbital pigmentation, visually increasing contrast between the hollow and adjacent areas.<br>In Geneva, where pollution levels are moderate but real, these factors must be considered during aesthetic assessment, particularly for patients exposed daily to an urban environment. Preventing these stressors is an integral part of a comprehensive, considered approach to ageing around the eyes.<\/p>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/drromanovaleria.ch\/wp-content\/uploads\/2024\/07\/photo-docteur-romano-valeria-150x150.webp\" alt=\"Photo of doctor Valeria Romano in Geneva\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n<p>Article written by <a href=\"https:\/\/drromanovaleria.ch\/en\/\">Dr Romano Valeria<\/a><\/p>\n<p>SHARE THIS ARTICLE ON<\/p>\n<p>\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" viewbox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 32H31.9C14.3 32 0 46.5 0 64.3v383.4C0 465.5 14.3 480 31.9 480H416c17.6 0 32-14.5 32-32.3V64.3c0-17.8-14.4-32.3-32-32.3zM135.4 416H69V202.2h66.5V416zm-33.2-243c-21.3 0-38.5-17.3-38.5-38.5S80.9 96 102.2 96c21.2 0 38.5 17.3 38.5 38.5 0 21.3-17.2 38.5-38.5 38.5zm282.1 243h-66.4V312c0-24.8-.5-56.7-34.5-56.7-34.6 0-39.9 27-39.9 54.9V416h-66.4V202.2h63.7v29.2h.9c8.9-16.8 30.6-34.5 62.9-34.5 67.2 0 79.7 44.3 79.7 101.9V416z\"><\/path><\/svg><br \/>\n\t\t\t\t\t\t\t\t\t\tLinkedIn\t\t\t\t\t\t\t\t\t<\/p>\n<ul>\n<li>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"mailto:dr.romano.valeria@gmail.com\"><br \/>\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" viewbox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M502.3 190.8c3.9-3.1 9.7-.2 9.7 4.7V400c0 26.5-21.5 48-48 48H48c-26.5 0-48-21.5-48-48V195.6c0-5 5.7-7.8 9.7-4.7 22.4 17.4 52.1 39.5 154.1 113.6 21.1 15.4 56.7 47.8 92.2 47.6 35.7.3 72-32.8 92.3-47.6 102-74.1 131.6-96.3 154-113.7zM256 320c23.2.4 56.6-29.2 73.4-41.4 132.7-96.3 142.8-104.7 173.4-128.7 5.8-4.5 9.2-11.5 9.2-18.9v-19c0-26.5-21.5-48-48-48H48C21.5 64 0 85.5 0 112v19c0 7.4 3.4 14.3 9.2 18.9 30.6 23.9 40.7 32.4 173.4 128.7 16.8 12.2 50.2 41.8 73.4 41.4z\"><\/path><\/svg><br \/>\n\t\t\t\t\t\t\t\t\t\tdr.romano.valeria@gmail.com<br \/>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n<li>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"tel:+41%2078%20209%2002%2089\"><br \/>\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" viewbox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M497.39 361.8l-112-48a24 24 0 0 0-28 6.9l-49.6 60.6A370.66 370.66 0 0 1 130.6 204.11l60.6-49.6a23.94 23.94 0 0 0 6.9-28l-48-112A24.16 24.16 0 0 0 122.6.61l-104 24A24 24 0 0 0 0 48c0 256.5 207.9 464 464 464a24 24 0 0 0 23.4-18.6l24-104a24.29 24.29 0 0 0-14.01-27.6z\"><\/path><\/svg><br \/>\n\t\t\t\t\t\t\t\t\t\t+41 78 209 02 89<br \/>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n<\/ul>","protected":false},"featured_media":0,"template":"elementor_header_footer","class_list":["post-27636","infographie","type-infographie","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Quelles sont les causes principales de l\u2019apparition de la vall\u00e9e des larmes ? - Dr Romano<\/title>\n<meta name=\"description\" content=\"La vall\u00e9e des larmes appara\u00eet principalement en raison de la fonte graisseuse malaire, du rel\u00e2chement cutan\u00e9, de la r\u00e9sorption osseuse et de facteurs g\u00e9n\u00e9tiques. 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