Medical Blepharoplasty in Switzerland: Rejuvenating the Eyes Without Surgery

Medical blepharoplasty refers to all the treatments that improve the appearance of the eyelids and eye area without surgery: injections, botulinum toxin, energy-based devices, surface lasers and peels. These techniques are attractive because they avoid the operating theatre and reduce downtime. Yet they have precise limitations: they do not remove significant excess skin or a large fat bag. This page helps you understand what each technique can really bring, who it suits, what its risks are, how long its effects last and how to choose a practitioner in Switzerland. For eyelid surgery, see our page on blepharoplasty in Switzerland.

Non-surgical treatments are mainly suited to the early stages of eye ageing: a hollow tear trough, fine wrinkles, slight skin laxity, a slightly low eyebrow tail. They do not replace blepharoplasty when excess skin or bags are pronounced. Their effects are temporary and require maintenance sessions. Injections around the eyes require great experience, because of the thinness of the skin and the presence of blood vessels. The relative budget is on our page on medical blepharoplasty prices in Switzerland.

The eye area ages faster than the rest of the face. Eyelid skin is the thinnest on the body, poor in sebaceous glands, and put under strain by thousands of blinks every day. Over time, it loses its elasticity and creases. Beneath the skin, the orbicularis muscle slackens, the septum that holds back the orbital fat stretches and lets bags appear, and the bone around the orbit is slightly reabsorbed, making the eyes look hollow.

The fat of the cheek also descends, which accentuates the tear trough and the separation between the eyelid and the cheek. The eyebrow, especially its outer part, drops and pushes the skin of the upper eyelid down. Each of these phenomena calls for a different treatment, which explains why precise analysis of the eyes is the first step.

The eyes are not judged in isolation: the cheekbones, temples, forehead and even the position of the eyebrows influence how the eyes are perceived. A cheek that has lost volume accentuates the tear trough; a hollow temple makes the eyebrow look lower; a very mobile forehead deepens crow's feet. Treating the cheekbone or temple sometimes improves the eyes more than an injection directly under them. The practitioner assesses the whole face before proposing a plan.

This table gives general guidance. Several signs often coexist, and the treatment plan sometimes combines medical and surgical steps.

Dark circles do not all have the same origin. Pigmented, brown dark circles are due to excess melanin in the skin, often hereditary and common on olive skin; they become more marked with sun and rubbing. Vascular, bluish or purplish dark circles reflect thin skin through which blood vessels and the colour of the underlying muscle show; they are more marked when tired. Hollow dark circles are linked to the tear trough, which creates a shadow.

The same eyes often combine several types. A simple test is to gently stretch the skin: if the colour persists, the dark circle is mainly pigmented; if it fades, or if the shadow disappears when you tilt your head towards the light, the hollow or vascular component dominates. Treatment follows from this diagnosis.

Not all bags are fat herniations. Bags that appear mainly in the morning and decrease during the day often reflect water retention, linked to sleep, salt, alcohol, allergies or hormonal changes. They respond to lifestyle measures and sometimes to draining skincare. Fat bags, by contrast, are present all the time and become more pronounced when you look upwards.

Some diseases, particularly of the thyroid or kidneys, can also cause swelling of the eyelids. A recent, rapid appearance of bags requires a medical consultation before any cosmetic treatment.

Many people notice puffier eyelids on waking, which settle during the morning. This puffiness is linked to fluid accumulating while lying down, encouraged by a salty meal, alcohol, allergies, lack of sleep or hormonal changes. It is not a matter for cosmetic treatment.

Sleeping with your head slightly raised, limiting salt and alcohol in the evening, applying cold compresses in the morning and treating any allergy often improve the situation. In people prone to this puffiness, hyaluronic acid injections under the eyes must be particularly cautious, as the product can retain water.

Hyaluronic acid injections

A resorbable gel is injected in small quantities, with a needle or cannula, to fill the tear trough, the hollow groove between the lower eyelid and the cheek, or sometimes the hollow of the upper eyelid. It softens the shadowed, tired look. It does not make a bag disappear; on the contrary, injected under a pronounced bag, it can accentuate it. See our page on hyaluronic acid injections.

Botulinum toxin

Injected into certain muscles, it softens crow's feet and can slightly lift the tail of the eyebrow by relaxing the muscle that pulls it down. It thus opens up the eyes a little, without acting on excess skin. See our page on botulinum toxin injections.

Plasma devices

Small electric arcs create micro-points of vaporisation on the surface of the skin, which cause slight contraction. They can improve a small excess of skin on the upper eyelid. The points form crusts for about a week, and there is a risk of dark marks on olive skin.

Radiofrequency

It heats the deep layers of the skin to stimulate collagen, alone or combined with microneedles. The tightening effect is gradual and modest, and often requires several sessions.

Surface lasers and peels

Fractional lasers and peels improve the texture, fine lines and radiance of the skin around the eye. Their effect on laxity is limited. See also our page on laser blepharoplasty.

Skin-hydrating injectables

Superficial injections of lightly cross-linked hyaluronic acid, sometimes combined with other substances, improve the hydration and quality of the thin skin under the eyes.

Hyaluronic acid is a resorbable gel naturally present in the skin. For the tear trough, soft, low-hydrophilic gels are used, injected in small quantities deep down, often against the bone, to support the hollow without creating swelling. The practitioner first assesses whether the skin is thick enough and whether the bags are not too large, two conditions for a good result.

The result is visible immediately and becomes more refined after one to two weeks. It often lasts six to twelve months, sometimes longer in this low-mobility area. A second small adjustment session is sometimes offered. Too much product or placement that is too superficial can create a bluish tinge or swelling, which can be corrected with the enzyme that dissolves the gel.

To inject the tear trough, some practitioners prefer the cannula, a flexible tube with a rounded tip that glides between the tissues, pushing blood vessels aside rather than piercing them. It reduces bruising and, according to many experts, the risk of vascular complications. Others use a fine needle, which allows the product to be placed very precisely against the bone, in small quantities and slowly.

Both techniques are legitimate in experienced hands. What matters most is knowledge of the anatomy, slow injection, small quantities and the ability to react if there is a problem. Do not hesitate to ask the practitioner why they choose one or the other.

Under the eyes, a few tenths of a millilitre of product per side is generally enough. Injecting more risks swelling, a bluish tinge and an artificial result, as the skin is very thin and the product attracts water. Cautious practitioners prefer to under-correct at the first session and add more two to four weeks later if necessary. This gradual approach gives more natural results and reduces the risks.

There are many hyaluronic acid products, which differ in firmness, ability to attract water and duration. For the tear trough, soft, low-hydrophilic gels suited to thin areas are chosen. Firmer gels, used for the cheekbones or chin, are not suitable under the eyes. The practitioner chooses the product according to the area and your skin; ask for its name and keep it in your file.

If you have already had injections under the eyes, mention it, with the date and the product name if possible. Residual product may still be present, even after several years, particularly in this low-mobility area. A new injection on top could create an excess. If necessary, the practitioner can dissolve the old product before reinjecting, or propose another approach. Permanent products require a specialist assessment.

Fat transfer, or lipofilling, uses the patient's own fat, taken with a fine cannula from the abdomen or thighs, purified and then reinjected in very small quantities. Around the eyes, it can fill the tear trough, the temples or the hollow of the upper eyelid, with a lasting result for the portion of fat that survives. It is a more involved procedure than hyaluronic acid, often performed in an operating theatre.

Fat can, rarely, create irregularities or small lumps under very thin skin, which are more difficult to correct than with hyaluronic acid. Fat transfer is often combined with blepharoplasty or a facelift. See our page on facial fat transfer.

Around the eyes, botulinum toxin has three main uses: softening crow's feet by relaxing the outer part of the orbicularis muscle, slightly lifting the tail of the eyebrow, and softening certain lower eyelid wrinkles at a low dose. Doses are low, injection points precise, and the effect lasts three to four months.

Too high a dose under the eyes can weaken the support of the lower eyelid and accentuate a bag or swelling, while spread towards the muscles of the upper eyelid can make it droop temporarily. These risks explain the caution of experienced practitioners and the importance of the post-injection instructions.

Injecting botulinum toxin directly under the eyes to soften fine lines on the lower eyelid is possible at a very low dose, but delicate: the orbicularis muscle contributes to supporting the lower eyelid and draining the area. Excessive relaxation can accentuate a bag, cause swelling or, rarely, change the position of the eyelid. This procedure is therefore reserved for selected patients without significant bags or laxity.

Crow's feet appear at the outer corner of the eye when you smile or squint, and eventually remain visible at rest. Botulinum toxin is the reference treatment for expression lines; it clearly softens them for three to four months. Lines that are established at rest also benefit from lasers, radiofrequency or skin-quality injectables.

Too high a dose can change the smile, making it look less natural, or weaken the support of the lower eyelid. An experienced practitioner doses botulinum toxin to soften the lines while preserving expression.

The eyes express our emotions: joy makes us squint, surprise raises the eyebrows, concentration draws them together. Overly heavy treatment can freeze these movements and give an expressionless or surprised look. Experienced practitioners dose botulinum toxin to soften lines while preserving mobility, and prefer small amounts of hyaluronic acid to keep a natural look both at rest and in motion. If your job depends on expression, as for actors, teachers or speakers, mention it.

Plasma devices create a micro-discharge of electricity between their tip and the skin, which vaporises a tiny point on the surface and heats the underlying tissues. After an anaesthetic cream, the practitioner applies a series of spaced points over the area to be tightened. As it heals, the skin contracts slightly. The treatment is mainly offered for slight excess skin on the upper eyelid and for fine lines.

The small crusts fall off within five to ten days, leaving pink skin for a few weeks. The result is gradual and varies from person to person; two or three sessions are often needed. On olive skin, the risk of brown marks is higher, which calls for caution and strict sun protection. Plasma should only be used by trained practitioners for well-established indications.

Radiofrequency delivers a current that heats the deep layers of the skin to a controlled temperature, which contracts existing collagen fibres and stimulates the production of new ones. Around the eyes, specific tips allow the thin skin of the eyelids to be treated without risk to the eye. Some devices combine radiofrequency with microneedles to work at a deeper level.

Sessions are well tolerated, with a sensation of warmth. The skin may stay pink for a few hours. The results, which are modest, appear over two to six months and mainly concern texture and slight firming. They suit people who want a gentle improvement without downtime.

Several types of laser are used around the eyes. Non-ablative fractional lasers improve texture and fine lines with short downtime. Ablative fractional lasers, such as CO2 or erbium, are more effective on wrinkles and skin laxity, but require one to two weeks of recovery. Pigment lasers target dark marks and some pigmented dark circles.

Specific eye protection, with shields placed over the eye, is essential for any laser used near the eyelids. The choice of laser and its settings depends on your skin type, the aim and your availability. See our page on laser blepharoplasty.

Peels apply an acid that exfoliates the surface layers of the skin and stimulates its renewal. Around the eyes, mainly gentle, superficial peels are used, which improve radiance, fine lines and some pigmentation. They are often performed as a series of a few spaced sessions. Medium or deep peels around the eyes are reserved for particular situations and very experienced practitioners.

After a peel, the skin may redden and flake for a few days. Sun protection is essential to avoid dark marks. Olive skin often needs to be prepared with creams before the peel.

So-called skin-quality injectables, based on lightly cross-linked hyaluronic acid, sometimes combined with amino acids or other molecules, are injected in small quantities into the skin by multiple micro-injections. They improve the hydration, elasticity and radiance of the thin skin around the eyes, and can soften fine lines and vascular dark circles. They do not add volume.

Two to three sessions a few weeks apart are generally offered, followed by maintenance. The effects are gradual and modest, appreciated by people looking for a natural improvement.

In some people, the upper eyelid does not droop but becomes hollow: the crease deepens, the eye looks sunken and the look older or more tired. This is linked to the loss of orbital fat, sometimes accentuated by an over-generous previous blepharoplasty, significant weight loss or certain glaucoma eye drops. Small injections of hyaluronic acid or fat into the hollow below the eyebrow can restore some fullness, with caution because of the proximity of important blood vessels.

A heavy upper eyelid is not always due to excess eyelid skin: often it is the eyebrow, particularly its outer part, that has dropped and pushes the skin down. In this case, slightly lifting the tail of the eyebrow with botulinum toxin can lighten the eyes without touching the eyelid. If the eyebrow is very low, a brow or temporal lift may be more effective than blepharoplasty alone. See our page on fox eyes.

With age and sun, the skin of the lower eyelid can take on a crinkled appearance, like crêpe paper, which becomes more marked when you smile. This superficial laxity responds poorly to volumising injections, but improves with treatments that stimulate collagen: fractional lasers, radiofrequency, skin-quality injectables, gentle peels and retinoids. Several sessions and regular sun protection are needed.

Bluish or purplish dark circles reflect very thin skin through which the blood vessels and the underlying muscle show. They become more marked with fatigue, lack of sleep, allergies and nasal congestion. Treatments aim to thicken the skin: skin-quality injectables, collagen-stimulating lasers, retinoids. A poorly placed hyaluronic acid injection can, conversely, accentuate the bluish tinge; in this situation, the practitioner remains very cautious.

Brown dark circles, common on olive skin and in some families, are due to excess pigment in the skin. They worsen with sun, rubbing the eyes and certain allergies. Treatments combine strict sun protection, depigmenting creams suitable for the eye area, gentle peels and, in some patients, pigment lasers used with caution to avoid a rebound effect. Results require patience and maintenance.

The eyelids can have small benign lesions: white spots, small skin-coloured bumps, yellowish deposits called xanthelasmas, or pigmented marks. They can be treated by a dermatologist or during a laser treatment. Any lesion that grows, bleeds, ulcerates, changes colour or causes lashes to fall out must be examined before any cosmetic treatment, as some skin cancers can affect the eyelids.

The term plasma refers to two different things in aesthetic medicine. The plasma used to tighten the skin is an electrical micro-discharge. Platelet-rich plasma, by contrast, is prepared from your own blood, centrifuged to concentrate the platelets, then injected into the skin to stimulate its regeneration. Around the eyes, it is sometimes offered to improve skin quality and dark circles. Evidence of its effectiveness remains limited and results vary; find out exactly what is being offered to you.

Microneedling creates multiple micro-perforations in the skin using fine needles, which stimulates collagen production. Around the eyes, it can improve texture and fine lines over several sessions, with redness for a few days. Intense pulsed light targets pigmented marks and small blood vessels, but must be used with strict eye protection and at a distance from the eye. These techniques are often integrated into an overall skincare plan.

Many devices are sold for home use: LEDs, microcurrent, small radiofrequency devices, massage rollers. Their effects on the eye area are modest, at best a temporary improvement in radiance or a reduction in morning puffiness. They do not replace medical treatments. Some devices, misused near the eyes, can irritate the skin or the eye; follow the instructions carefully and avoid the area close to the eyeball.

For a long time, the only way to rejuvenate the eyes was eyelid surgery. From the 1990s, botulinum toxin, first used in neurology and ophthalmology to treat involuntary eyelid contractions, became a reference treatment for expression lines. Injectable hyaluronic acids developed in the 2000s, allowing volume to be restored reversibly. Fractional lasers, radiofrequency and, more recently, plasma and skin-quality injectables have completed the range.

These techniques have broadened the options, but they have not replaced surgery, which remains the solution for excess skin and bags. The current trend is towards combined, measured and personalised approaches.

• Remove excess skin that clearly hangs over the crease of the upper eyelid.
• Eliminate a pronounced fat bag under the eyes.
• Correct ptosis, that is, an eyelid that droops because of weakness of the levator muscle.
• Lastingly lift a clearly dropped eyebrow.
• Correct a lax or turned lower eyelid.
• Restore a visual field reduced by eyelid skin.

In these situations, surgery remains the solution. An honest practitioner will tell you so rather than multiplying sessions with limited effects. The right choice depends on a precise examination of the eyes.

The central question of any consultation is whether medical treatment will be enough or whether surgery is preferable. A few guidelines help: if the skin of the upper eyelid hangs over the lashes or reduces the visual field, surgery is necessary. If fat bags are visible all the time, even at the end of the day, a lower blepharoplasty will give a clearly superior result. If the main problem is thin skin, fine lines, a hollow or dark circles, medical treatments are often suitable.

Many patients fall somewhere in between. The practitioner then explains honestly what each option can bring, and what maintaining medical treatments will cost over several years compared with surgery. The decision is yours, but it must be an informed one.

• The skin of the upper eyelid touches the lashes or obstructs vision.
• The bags are visible all day, including in profile.
• Successive injections cause swelling or a disappointing result.
• The annual budget for treatments is becoming significant.
• The laxity extends to the eyebrow and cheek.

In these situations, a surgical opinion allows the options to be compared objectively. See our page on blepharoplasty.

Some situations lie on the border between medical treatment and surgery: a moderate bag combined with a pronounced hollow, slight upper excess skin in someone who does not want an operation, eyes that look hollow after weight loss. In these cases, the practitioner may suggest trying medical treatment, explaining clearly that the result will be partial and that surgery will remain an option if the improvement is not enough.

This gradual approach suits many patients, provided they accept its limitations and do not multiply sessions in the hope of obtaining a result that only surgery can provide.

The two approaches are often complementary: surgery treats the structure, medical treatments the quality of the skin. See our page on blepharoplasty.

In surgery, the current trend is often to reposition the fat from the bags to fill the tear trough, rather than removing it entirely, to avoid hollow eyes. This surgical approach, sometimes called blepharoplasty with fat transposition, gives a more natural and lasting result than leaving the bags in place and repeating injections. It illustrates why a surgical opinion is useful when bags and hollows coexist.

Medical treatments of the eye area give real but modest results: a more rested look, smoother skin, a softened hollow, a slightly higher eyebrow. They do not transform very tired eyes, do not eliminate fat bags and do not replace surgery when it is indicated. Promises of "blepharoplasty without surgery" should be read with caution.

The most satisfied people are those who were looking for a subtle improvement and who had fully understood the limitations of these treatments before starting.

The expression "blepharoplasty without surgery" is often used in marketing, with spectacular before-and-after photos. Some are taken just after the treatment, when swelling gives an impression of taut skin, others with different lighting or angles. A genuine result is judged after several months, under the same photo conditions.

Be wary of promises to eliminate bags, guaranteed or permanent results, and offers that mention neither the limitations nor the risks. An honest practitioner also explains what the treatment will not be able to do, and does not hesitate to refer you for surgery when it is more appropriate.

Botulinum toxin and hyaluronic acid have been the subject of many studies confirming their effectiveness for crow's feet and the tear trough, with a favourable safety profile in experienced hands. Fractional lasers and radiofrequency have demonstrated an improvement in texture and fine lines, more modest on laxity. For plasma, the data are more limited and results more variable. For platelet-rich plasma and some recent devices, the evidence remains insufficient.

These data help in choosing treatments whose benefits are established, and in remaining cautious about novelties.

Satisfied patients describe a more rested look, softer dark circles or smoother skin, often noticed by those around them without identifying the treatment. They stress the importance of a practitioner who took the time to explain the limitations and started cautiously. Disappointments mainly come from expectations that were too high, particularly the hope of removing fat bags without surgery, or from swelling after over-generous injections.

• The consultation: hollows under the eyes, few bags, skin of good thickness; hyaluronic acid proposed.
• The day: anaesthetic cream, injection with a cannula, thirty minutes.
• The evening: slight swelling, cold compresses.
• Days 2 to 5: a small bruise on one side, hidden with make-up.
• Two weeks: check-up, natural result, no touch-up needed.
• Nine months: the hollow reappears slightly; small maintenance session.

• The consultation: slight excess skin on the upper eyelid, surgery declined; plasma proposed, modest result explained.
• Session 1: anaesthetic cream, forty minutes, prickling.
• Days 1 to 7: small crusts, puffiness in the morning, no make-up.
• Two months: skin slightly tighter; second session.
• Six months: eyelid slightly more defined, pleased to have avoided surgery for now.

• Laura, 32, hollow dark circles without bags: hyaluronic acid in a small quantity.
• Karim, 38, pigmented dark circles on olive skin: depigmenting creams, gentle peels, sun protection.
• Anne, 45, crow's feet and drooping eyebrow: botulinum toxin.
• Martine, 52, thin skin and fine lines: a series of fractional laser sessions in winter.
• Pierre, 55, pronounced fat bags: referred for a lower blepharoplasty.
• Hélène, 64, excess skin touching the lashes: upper blepharoplasty, then laser for skin quality.

A simple routine prolongs the effects of treatments and protects the thin skin around the eyes: gentle cleansing without rubbing, with a suitable make-up remover; moisturiser morning and evening; sunscreen suitable for the eye area and sunglasses outdoors. In the evening, a cream containing a gentle retinoid can improve texture, introduced gradually and never just after a laser or peel.

Avoid rubbing your eyes, a habit that irritates the skin, accentuates pigmented dark circles and can encourage corneal problems. Cold compresses in the morning reduce temporary puffiness.

Sleep, diet and lifestyle play an important role in the appearance of the eyes. Lack of sleep accentuates vascular dark circles and puffiness; a salty meal or alcohol the night before encourage morning bags. Sleeping with your head slightly raised, limiting salt in the evening, staying well hydrated and treating allergies often improve eyes that are puffy on waking.

Smoking and repeated sun exposure accelerate ageing of the skin around the eyes. Stopping them is one of the most effective measures for preserving your eyes, and for prolonging the effects of treatments.

Poorly suited vision correction makes you squint and frown, which deepens crow's feet and the frown line, and gives a tired look. Having your eyesight checked, particularly after forty with the onset of presbyopia, is a simple measure that relaxes the eyes. Frames also play a role: a thick frame can accentuate the impression of dark circles, whereas a lighter frame or anti-reflective lenses brighten the eyes.

Lack of sleep accentuates vascular dark circles, puffiness and a dull complexion. Conversely, regular nights, a cool, dark bedroom and a slightly raised position reduce morning puffiness. Sleeping on your front or side, with your face pressed against the pillow, can encourage certain skin creases over the years. A soft pillowcase limits friction. These simple habits effectively complement treatments and cost nothing. They are often the practitioner's first recommendation, even before any medical procedure, as they often improve the eyes more than you might imagine.

The eyelids react easily to seasonal allergies, cosmetics, nail varnish or eye drops, with swelling, redness, itching and flaking. Eyelid eczema must be calmed before any cosmetic treatment, and the allergen identified if flare-ups keep recurring. Bags and dark circles linked to allergies often improve with anti-allergy treatment, before other procedures are considered.

Prolonged screen work tires the eyes: we blink less, the surface of the eye dries out, and we often squint, which works the crow's feet muscles. The eyes then look more tired at the end of the day. Regular breaks, a well-positioned and well-lit screen, artificial tears if needed and suitable vision correction reduce this strain, independently of any cosmetic treatment.

On video calls, a camera placed below the face, overhead lighting and closeness to the lens accentuate dark circles, bags and eyelid laxity. Before considering treatment, it is useful to place the camera at eye level, light your face from the front with soft light and keep some distance. These simple adjustments often make a big difference to how the eyes look on screen.

A well-chosen concealer greatly softens dark circles: a peach or orange shade for bluish or brown dark circles, applied in a small quantity in the hollow of the tear trough, then a light, luminous texture on top. Avoid concealers that are too thick or too light, which emphasise fine lines and the hollow. After a treatment, wait for the practitioner's approval before applying make-up to the area again, and use clean products.

After blepharoplasty, medical treatments can perfect the result: laser or radiofrequency for skin quality, botulinum toxin for crow's feet, a cautious injection for a residual tear trough. They are generally performed a few months after the procedure, once healing is complete. The practitioner takes account of the changes in anatomy and the scars. Bring your operative report.

Medical treatments do not freeze the face: the skin continues to age and the products are reabsorbed. Regular maintenance keeps the results going: botulinum toxin two to three times a year if you wish, a tear trough injection roughly every twelve to eighteen months, and periodic laser or radiofrequency sessions. Spacing sessions out as much as possible avoids accumulating product and preserves a natural appearance.

The result is judged after some time: two weeks after an injection or botulinum toxin, two to three months after plasma, radiofrequency or a laser. Compare photos taken before and after in the same lighting conditions and without make-up. A discreet, natural result is often the sign of a successful treatment, even if it looks less spectacular than some advertisements promise.

A successful treatment is one you are happy with, not just a result the practitioner considers satisfactory. If you feel less comfortable with your eyes, if the effect seems artificial to you or if you no longer recognise yourself, say so. As medical treatments are temporary and often reversible, it is always possible to adjust, take a break or stop.

• The name and batch number of each product injected.
• The doses of botulinum toxin and the areas treated.
• The settings and type of laser or device used.
• The dates of each session.
• Before-and-after photos.

This information is invaluable for adjusting later sessions, in the event of a complication, if you change practitioner or before eyelid surgery.

A small touch-up is common after injections, two to four weeks after the first session, to complete a hollow that is still visible or balance the two sides. After botulinum toxin, an adjustment can be made at two weeks. For lasers, plasma and radiofrequency, several sessions are generally planned from the outset. Ask before the treatment about touch-up conditions and any cost.

Between medical treatments, regular care can maintain the quality of the skin around the eyes: professional moisturising treatments, very gentle peels, draining treatments. Beauty salons offer comfort treatments that moisturise and relax, useful as a complement but with no effect on hollows, bags or laxity. Always tell the practitioner and the beautician about recent treatments, to avoid unsuitable treatments on weakened skin.

An annual review with your practitioner allows the changes in your eyes and the durability of the treatments to be assessed, and the plan adjusted: spacing out certain procedures, adding others, or considering surgery if your needs have changed. It is also an opportunity to check skin quality, the appearance of small lesions or marks to be monitored, and to update your file.

Treatments can be stopped at any time, with no rebound effect: the effects gradually disappear and the eyes return to their natural course. The treatments have not made the skin age faster. Some people decide at some point to switch to longer-lasting surgery; others prefer to return to simple skincare and good sun protection.

• "You can get rid of bags without surgery": rarely — fat bags almost always require surgery.
• "Injections under the eyes are trivial": no — the area requires great experience.
• "Plasma replaces blepharoplasty": only for very slight laxity.
• "Botulinum toxin makes the eyelids droop": rarely, and only temporarily.
• "The more you inject, the better": false — excess creates swelling and a bluish tinge.
• "Creams erase dark circles": they help a little, without correcting a hollow.

• The consultation: thin skin and fine lines on the lower eyelid, no bags; radiofrequency proposed.
• Session 1: thirty minutes, sensation of warmth, skin pink for an hour.
• Sessions 2 and 3: a month apart, same procedure.
• Three months: skin slightly smoother and firmer, a discreet but real effect.
• One year: maintenance session, daily sun protection.

• The consultation: crow's feet, hollows under the eyes and dull skin; a three-step plan.
• Step 1: botulinum toxin for crow's feet.
• Step 2: two weeks later, a small quantity of hyaluronic acid in the tear trough.
• Step 3: during the winter, three sessions of skin-quality injectables.
• Six months: a rested look, with nobody around her identifying any specific change.

Early ageing of the eyes

Between thirty-five and fifty, when the tear trough starts to deepen, crow's feet appear and the skin loses some firmness, without excess skin or pronounced bags.

People who do not want surgery

For them, these treatments improve the appearance of the eyes, accepting a more modest and temporary result.

As a complement to surgery

After blepharoplasty, botulinum toxin, lasers or injections maintain and complement the result.

Situations to avoid

Significant bags, very lax skin, untreated dry eyes, a history of reactions to injected products, local infection, pregnancy and breastfeeding.

Some people have pronounced bags or dark circles from their twenties, often hereditary. They naturally turn to medical treatments, which are perceived as lighter. Yet repeated injections in an area where a fat bag is present often give disappointing results, or even swelling. A lower blepharoplasty through the internal approach, with no visible scar, is often more suitable and longer lasting, even in a young person.

Significant weight loss often makes the eyes look hollow: the tear trough and the hollow of the upper eyelid become more marked, and the face looks older. Conversely, weight gain can mask some hollows but weigh down the eyelids. It is preferable to consider volumising injections once your weight has stabilised, so that the result remains harmonious.

During pregnancy and breastfeeding, treatments are postponed. After childbirth, lack of sleep often accentuates dark circles and puffiness, which improve spontaneously once routines settle. It is advisable to wait until breastfeeding has ended and for a few months of recovery before judging whether treatment is appropriate. Pigmented dark circles can also become more marked during pregnancy and fade gradually afterwards.

Injections under the eyes are increasingly requested by young people, sometimes after seeing videos online. In them, dark circles are often linked to genetics, lack of sleep, allergies or thin skin, and not always to a hollow. An injection may then give a disappointing result, or even swelling. A careful assessment, lifestyle measures and skincare are often a better starting point.

It is sometimes said that injections should be started early to prevent ageing. For the skin, the best prevention remains sun protection, not smoking, good sleep and suitable skincare. Low-dose botulinum toxin can limit the deepening of expression lines in some people, but volumising injections in young people with no real hollow have no proven value. It is better to treat a real sign than to anticipate an absent one.

After sixty, the skin around the eyes is thinner and less elastic, and bags and excess skin are more pronounced. Medical treatments can improve skin quality and soften certain hollows, but their effect on very lax eyes is limited. Surgery, possibly combined with skin treatments, often gives a more satisfactory result. Medical treatments remain useful for people who do not wish to, or cannot, have surgery.

Men often seek advice for dark circles, bags or tired-looking eyes, sometimes prompted by people they work with. Their skin is thicker, which changes how it responds to treatment: botulinum toxin sometimes requires slightly higher doses, and injections under the eyes must remain discreet so as not to create visible swelling. The male eyebrow, lower and more horizontal, must not be lifted too much, at the risk of feminising the eyes.

Men who seek advice about their eyes often describe a tired or stern look that does not match how they actually feel, noticed in meetings or on video calls. They want discreet results, without a groomed appearance, and a quick recovery compatible with their working life. Measured-dose botulinum toxin for crow's feet, a small injection in the tear trough or a gentle laser often meet these expectations. Pronounced bags, common in men, are more a matter for surgery.

Olive and dark skin has good resistance to skin ageing, but more often has pigmented dark circles. It is also more prone to brown marks after treatments that injure the skin's surface, such as ablative lasers, plasma or medium peels. The practitioner favours gentle techniques, prepares the skin with depigmenting creams, adapts the settings and insists on sun protection.

Injections and botulinum toxin pose no particular risk related to skin colour.

Sensitive skin, prone to redness or rosacea, reacts more to lasers, peels and certain products. Rosacea can also affect the eyelids and eyes, with irritation and dryness. It must be stabilised before cosmetic treatment, and techniques and settings adapted to this sensitivity. Vascular lasers can in fact improve redness and small visible blood vessels.

• Pregnancy and breastfeeding.
• Infection, eczema or active cold sores in the area.
• Neuromuscular diseases, for botulinum toxin.
• History of a severe reaction to an injected product.
• Permanent products already injected under the eyes.
• Recent isotretinoin acne treatment, for lasers and peels.
• Tendency to thick scarring, for ablative treatments.
• Thyroid disease affecting the eyes, to be assessed.

Some thyroid diseases, particularly Graves' disease, can cause swelling of the eyelids, red and dry eyes, and a look that appears more open or staring. These signs call for specialist medical care, not cosmetic treatment. Recent eyelid swelling that appears quickly or is associated with other symptoms requires a medical consultation before any cosmetic step.

At menopause, falling hormone levels thin the skin, reduce its collagen production and encourage dryness, including dry eyes. Fine lines around the eyes become more marked and the skin loses elasticity. Treatments that stimulate collagen, such as lasers, radiofrequency and skin-quality injectables, together with a suitable skincare routine and sun protection, help preserve skin quality. Dry eyes must be treated, particularly before treatments near the eye.

Smoking is one of the main accelerators of ageing of the skin around the eyes: it reduces tissue oxygenation, breaks down collagen and encourages fine wrinkles and a dull complexion. It also shortens the duration of treatment results and slows healing after a laser or plasma treatment. Stopping smoking is a genuine preventive treatment for the eyes.

People prone to cold sores can have a herpes outbreak after a laser, plasma or peel, even if the treated area is around the eyes. Herpes on healing skin can leave scars. That is why preventive antiviral treatment is often prescribed before these treatments, and why an active cold sore requires the session to be postponed. Always mention this history.

Anticoagulants, aspirin, certain anti-inflammatories and supplements such as omega-3s, ginkgo, garlic or vitamin E increase the risk of bruising after injections. Anticoagulants prescribed for a medical reason must never be stopped without the advice of the doctor who prescribed them. The practitioner then adapts their technique, for example by using a cannula, and warns you of a risk of more marked bruising. For supplements, stopping them for a few days before the session may be advised.

Some autoimmune or inflammatory diseases and treatments that modulate immunity can increase the risk of delayed reactions to injections or disrupt healing after a laser. Treatments are not necessarily contraindicated, but they are discussed during a stable period, with the agreement of the doctor managing the disease, and with suitable products and doses.

Dry eyes are common, particularly after fifty, in post-menopausal women, contact lens wearers and people who work at screens. They cause burning, a gritty sensation and red eyes, which accentuate the impression of tiredness. Some treatments, such as botulinum toxin around the eye or lasers close to the eyelids, can temporarily change it.

It is useful to mention it and, if necessary, treat it before starting: artificial tears, warm compresses and eyelid margin care. An ophthalmological opinion is advisable if it is significant. A comfortable eye also makes the eyes look more rested.

Before an injection, avoid if possible aspirin, anti-inflammatories and certain supplements that encourage bruising, on medical advice, and do not schedule the session just before an important event. Come without make-up. Before a laser, plasma or peel, avoid the sun and self-tanners in the preceding weeks, prepare your skin with the prescribed creams if necessary, and mention any history of cold sores.

Always mention your treatments, allergies and any injections already performed, with the product names if you know them.

• Welcome and review of your expectations and medical history.
• Photographs before treatment.
• Cleaning and disinfection of the skin, anaesthetic cream if needed.
• Marking the injection points, sometimes with a pencil.
• Slow injection, in small quantities, checking the result.
• Gentle moulding and checking with you sitting up.
• Application of cold and written instructions.

• The first few hours: cold through a cloth, no massage, no make-up.
• The evening: head slightly raised for sleeping.
• Days 1 to 3: slight swelling possible, especially in the morning; a small bruise may appear.
• Days 3 to 7: the swelling disappears and the result emerges.
• Two weeks: check-up and possible adjustment.

For the first forty-eight hours, avoid intense sport, the sauna, steam rooms, alcohol and exposure to heat. Do not lie on your front the first night.

• Days 1 to 3: redness, swelling, a feeling of heat; crusts after plasma.
• Days 3 to 7: peeling or crusts falling off; the skin remains pink.
• Two weeks: skin healed, pink, make-up possible.
• One to three months: the redness disappears and the firming effect builds.

Moisturise generously with the prescribed cream, do not rub or pick off the crusts, avoid the sun completely and use a mineral sunscreen as soon as the skin tolerates it. Preventive treatment against cold sores may be prescribed.

After an injection or botulinum toxin, glasses and contact lenses can be worn normally, avoiding pulling on the eyelid skin when inserting the lenses. After a laser or plasma treatment close to the eye, it is better to wear glasses for a few days while the skin heals, and to avoid frames pressing on the treated areas. Sunglasses are very useful to protect the treated skin and hide bruising.

After an injection, sleep on your back with your head slightly raised for the first night or two, to limit swelling and avoid pressing on the treated area. After a laser or plasma treatment, the same position and a clean pillowcase, changed often, help healing. After botulinum toxin, simply avoid lying down for four hours after the injection.

Intense sport increases blood flow to the face and can accentuate swelling or bruising after an injection: wait twenty-four to forty-eight hours. After a laser or plasma treatment, wait until healing is complete, and avoid heavy sweating and swimming pools. The heat of the sauna and steam room should be avoided for the same period. The sun is the enemy of skin treated by laser, plasma or peel: strict protection for several weeks, especially in the mountains.

• Can I have a glass of wine on the evening of an injection? It is better to wait until the next day; alcohol encourages bruising.
• Can I fly after an injection? Yes, after a few days, keeping your skin well moisturised.
• Can I have my eyebrows shaped? Yes, avoiding the days immediately after the session.
• Can I have a beauty treatment? After about two weeks, mentioning the treatment.
• Can I use my usual serum? Yes after an injection, but not on laser-treated skin before it has healed.

Outdoor athletes — runners, cyclists, skiers or hikers — expose their eyes to sun, wind and cold, which accelerate ageing of the skin around the eyes and encourage dark marks and crow's feet. Wraparound sunglasses, a sunscreen suitable for the eye area and a moisturiser protect this area. After a surface treatment, a break of a few weeks from activities in full sun is necessary.

Most medical treatments of the eye area allow you to return to work immediately, or after one to three days if there is swelling or bruising after an injection. After plasma or an ablative laser, allow a few days to a week of discretion, especially if you are in contact with the public or on video calls. Scheduling these sessions before a weekend or holiday is often convenient.

Most medical treatments of the eye area are discreet: those around you often notice a rested look without identifying any change. After an injection or plasma, small bruises, swelling or crusts may be visible for a few days. Those close to you can help you watch for warning signs and remind you of the instructions, particularly not to rub the area and to protect yourself from the sun.

Young children readily touch their parents' faces. After an injection, laser or plasma treatment, it is better to prevent them from pressing on or touching the treated area, especially in the first few days. Good hand hygiene before applying creams and touching the area limits the risk of infection. These precautions are simple and short-lived.

Medical treatments of the eye area do not generally require any particular help: you can go home alone after the session, unless you have been sedated. Simply keep the practitioner's number to hand, prepare cold compresses and the prescribed creams, and do not hesitate to call if in doubt.

• "Have you had something done?" With measured procedures, people mainly notice a rested look.
• "Does it hurt?" Injections and lasers are well tolerated with an anaesthetic cream.
• "Is it permanent?" No, the effects last from a few months to one or two years.
• "Why not have an operation?" Because my skin and hollows called for medical treatment, or because I did not want surgery for now.

For surface treatments such as lasers, plasma and peels, autumn and winter are the best seasons: the sun is less intense and the risk of dark marks is reduced. For injections and botulinum toxin, any season is suitable, provided you avoid intense sun exposure or travel in the following days. In the mountains, reflection off the snow requires sun protection and sunglasses even in winter.

In Switzerland, mountain sun is intense even in winter, with strong reflection off the snow. After a laser, plasma or peel, ski trips should be avoided for several weeks, or you should protect yourself very carefully, so as not to trigger dark marks. After an injection or botulinum toxin, skiing is possible after a few days, with suitable sunglasses and a sunscreen suitable for the eye area.

For a wedding, photo shoot or professional event, plan ahead: botulinum toxin at least two to three weeks before, hyaluronic acid two to three weeks before, and lasers and plasma at least a month before, longer for ablative treatments. Avoid any new treatment in the preceding week, and do not try a new skincare or make-up product just beforehand.

Tired-looking eyes often combine several signs: crow's feet, hollows, thin skin, pigmented dark circles. Rather than multiplying procedures at random, the practitioner builds a plan, for example: botulinum toxin for crow's feet and the eyebrow, then hyaluronic acid for the tear trough two weeks later, then a series of laser or skin-quality injectable sessions during the winter. Each step is assessed before the next.

This plan takes account of your budget, availability and the seasons. It can be adjusted along the way according to the results.

When several treatments are planned, the order matters. In general, botulinum toxin is performed first, as it changes the position of the eyebrow and the movement of the muscles; the need for volume is then assessed, and injections are performed. Surface treatments such as lasers and peels are often scheduled at a distance from injections, for example two weeks later, so as not to disturb the product or worsen swelling. The practitioner sets the most suitable timetable.

The intervals between sessions depend on the treatment: at least three months between two botulinum toxin sessions, several months between two hyaluronic acid injections in the same area, and generally four to six weeks between two laser, plasma or radiofrequency sessions, while the skin regenerates. Respecting these intervals allows the effect of each session to be assessed, limits accumulation of product and reduces the risks. Bringing sessions closer together does not speed up results and may, on the contrary, irritate the skin or create excess volume.

The practitioner draws up a suitable timetable with you, which they adjust according to how your skin responds and your priorities. Note the date of each session in your file or diary: this makes follow-up easier, avoids sessions being too close together and allows you to judge better, over the months, what works best for your eyes. If in doubt about the right time, simply ask the practice, which has the history of your treatments and can suggest the most suitable date, taking into account the season, your plans and how your skin has changed since the last session.

Some people want treatments with no downtime at all, others accept a few days of discretion for a more marked result. Business travel, outdoor sport, ski seasons and family commitments influence the choice of techniques and their timing. Discuss this at the consultation: a plan adapted to your lifestyle will be followed better and give better results.

Damage to a blood vessel

This is the most serious risk of facial injections, rare but real: if the product enters a blood vessel or compresses it, it can cause skin compromise and, exceptionally, damage to vision. Intense pain, pallor or abnormal skin colour, or a visual disturbance during or after an injection require immediate treatment. The practitioner must have the product that dissolves hyaluronic acid and know how to use it.

A bluish tinge

Hyaluronic acid injected too superficially under the thin skin of the eyelids can give a visible bluish tint. It is corrected by dissolving the product.

Persistent swelling

Hyaluronic acid retains water; poorly chosen or used in excess under the eyes, it can cause lasting swelling, sometimes more visible in the morning.

Drooping eyelid after botulinum toxin

If the toxin spreads to the levator muscle, the eyelid may droop for a few weeks. This rare risk is limited by precise injection and following the instructions.

Dark marks and burns

After plasma, laser or peels, brown marks may appear, especially on olive skin and with sun exposure.

Bruising

Common after injections around the eyes, it disappears within one to two weeks.

In the event of intense pain, a change in skin colour or visual disturbance after an injection, contact the practitioner immediately; in the event of visual disturbance, call 144.

These complications are rare with an experienced practitioner who adapts the treatment to your skin and anatomy. Knowing about them allows you to react quickly if an unusual sign appears.

Around the eyes, arteries connect the skin of the face to the circulation of the eye. If hyaluronic acid accidentally enters one of them, it can block the flow of blood. This shows up as intense, unusual pain, pallor and then purplish or mottled skin, and sometimes a visual disturbance. It is an absolute emergency.

The practitioner must immediately inject the enzyme that dissolves the gel and take other measures. A visual disturbance requires emergency ophthalmological care. This risk is very rare, but it justifies choosing a doctor trained in this area, who uses safety techniques and has the enzyme on site.

The bluish tinge appears when the gel is placed too close to the surface, under thin skin: light is scattered and gives a blue tint. Persistent swelling occurs mainly in people who retain water under the eyes or when too much product has been injected. These two problems are not dangerous, but they are unsightly and can last for months. They are corrected by dissolving the product with the enzyme and then, if necessary, reinjecting a small quantity more deeply later.

Rarely, weeks or months after a hyaluronic acid injection, a reaction can appear: swelling, redness or small lumps under the skin, sometimes after an infection, vaccination or dental treatment. These inflammatory reactions are treated with medication, the enzyme that dissolves the product or other treatments depending on their cause. They justify keeping a record of the products injected and consulting the practitioner if an unusual change appears, even long afterwards.

After a laser, plasma or peel, healing skin is very sensitive to sun and inflammation. Brown pigmentation can appear a few weeks later, especially on olive skin or with sun exposure. It generally fades within a few months with depigmenting creams and strict sun protection. More rarely, an area may become lastingly lighter.

To limit this risk: prepare the skin if necessary, avoid the sun before and after, do not pick off the crusts, and choose settings suited to your skin type.

In the past, permanent or semi-permanent fillers were injected into the face, sometimes under the eyes. Years later, they can cause nodules, inflammation, deformities or chronic swelling that are very difficult to treat, sometimes only surgically. Around the eyes, only resorbable products such as hyaluronic acid should be used. If you have received a product whose nature you do not know, mention it before any new treatment.

• Intense, unusual or increasing pain.
• Pallor, purplish or mottled skin.
• Visual disturbance, even temporary.
• Spreading redness, warmth, fever, discharge.
• Significant swelling that appears quickly.
• A drooping eyelid that obstructs vision.

In these situations, contact the practitioner immediately. In the event of visual disturbance or if the practitioner cannot be reached, go to the emergency department, stating the treatment performed and the product used.

The risk of infection after an injection or surface treatment is low, but it exists. To reduce it: come without make-up, let the practitioner disinfect carefully, do not touch the area with your fingers for the first few hours, do not apply make-up until allowed, avoid swimming pools and saunas during healing, and use clean or new make-up products. Increasing redness, warmth or discharge require prompt medical attention.

Before leaving the practice, save the practitioner's number in your phone, including the number to call outside opening hours. In the event of visual disturbance, intense pain or a change in skin colour after an injection, every minute counts: call immediately and, if no one answers, go to the emergency department, ideally at a hospital with an ophthalmology department, or dial 144. State the product injected and the time of the injection.

In Switzerland, botulinum toxin and hyaluronic acid injections are medical procedures. Offers made by non-doctors, in beauty salons, at home or at events, as well as devices sold for personal use such as needle-free injection pens, expose you to products of unknown quality and serious complications, particularly around the eyes. Surface treatments in salons can be pleasant, but their effects are limited; active treatments must remain medical.

• Injecting fat bags instead of operating on them.
• Choosing a practitioner with little experience of this area.
• Accepting a product whose name you do not know.
• Exposing yourself to the sun after a laser or plasma treatment.
• Picking off crusts.
• Multiplying sessions with different practitioners without a file.
• Ignoring intense pain or a visual disturbance after an injection.

In Switzerland, injections are medical procedures carried out by doctors. They are performed in particular by dermatologists, plastic surgeons, doctors specialising in aesthetic medicine and some ophthalmologists. For the delicate eye area, choose a doctor who treats it regularly, knows the vascular anatomy and has the product that dissolves hyaluronic acid. Check their title in the MedReg register. Be wary of very low-priced offers, products whose origin is not specified and promises of results equivalent to surgery.

• Do my eyes call for medical treatment or surgery?
• Which product or device do you propose, and why?
• How many sessions, and how long will the effect last?
• What are the risks in my situation, and how do you manage them?
• Do you have what is needed to dissolve hyaluronic acid in the event of a complication?
• What does the price include, including touch-ups?

Because these treatments are carried out in the consulting room, without an operating theatre, provision is much more widely spread across the country than for surgery. The practitioner's experience of the eye area remains the main criterion, more than proximity.

The consultation starts with your expectations: what bothers you most, since when, and what you have already tried. The practitioner then examines your eyes from the front and in profile, in good light, asking you to look up, close your eyes, smile and raise your eyebrows. They assess the thickness and quality of the skin, the presence of bags, the depth of the tear trough, the position of the eyebrows, wrinkles and the colour of dark circles.

They tell you whether medical treatment is suitable, which one, what you can expect from it, how many sessions will be needed, and whether they think surgery would be more effective. A written quote and a period of reflection follow.

• Note what bothers you most and in which situations.
• Bring photos of yourself from ten years ago, which help to understand the changes.
• List your treatments, allergies and medical history, including cold sores.
• Mention any injections or surgery already performed, with the products.
• Come without eye make-up.
• Prepare your questions about limitations, risks and cost.

• Does my problem call for medical treatment or surgery?
• Which treatment do you recommend, and why?
• What result can I expect, and for how long?
• How many sessions are needed, and at what total cost?
• Which product do you use, and can you dissolve it if needed?
• What are the risks in my case?
• What happens in the event of a complication?
• How many under-eye injections do you perform each month?

• From the front, looking straight ahead, without make-up, in daylight.
• From the front, looking upwards, to reveal the bags.
• In profile on each side.
• Three-quarter view on each side.
• Without filters or retouching, at eye level.

Add a few words about what bothers you and the treatments already performed. This information allows initial guidance, before an essential in-person consultation.

In French-speaking Switzerland, Geneva and Lausanne offer the greatest variety of practitioners and equipment, with dermatologists, plastic surgeons, aesthetic doctors and oculoplastic surgeons. The Riviera, Nyon, Fribourg, Neuchâtel and Sion also have practices equipped with lasers and radiofrequency devices. In Jura and the Valais valleys, injections are available locally, lasers more often in the neighbouring town.

In German-speaking Switzerland, Zurich has the widest range, followed by Basel, Bern, Lucerne and St. Gallen. In Ticino, Lugano and Bellinzona offer all treatments, with consultations in Italian. For a programme of several sessions, having the practice nearby makes organisation much easier.

For residents of mountain regions or small cantons, injections and botulinum toxin are often available locally, but some lasers or devices are only available in the major cities. Group sessions together, ask whether a first opinion can be given from photos, and whether some check-ups can be done remotely. For under-eye injections, favour an experienced practitioner, even if it means travelling.

Provision changes rapidly and depends on each practice's equipment. The practitioner's experience in the eye area counts for more than the city.

• A doctor holding a specialist title, verifiable in the MedReg register.
• Specific experience with injections under the eyes.
• Ability to refer you for surgery if it is more appropriate.
• Dissolving enzyme and emergency protocol available.
• Authorised, traceable products, named on the quote.
• Well-maintained equipment and settings adapted to your skin.
• Organised follow-up and a contact number.

Be wary of promotional packages, sessions offered without a prior consultation and promises of "blepharoplasty without surgery" that would make bags disappear.

• Injecting pronounced fat bags rather than referring for surgery.
• Using permanent products around the eyes.
• Injecting large quantities in a single session.
• Performing a surface treatment on tanned skin or with an active cold sore.
• Promising a permanent or guaranteed result.
• Treating without a prior consultation or information about the risks.

Injections and skin treatments around the eyes must be performed under strict hygiene conditions: careful disinfection of the skin, sterile single-use products, protective glasses or shields for lasers, and maintained and checked devices. The practice must have a protocol for complications, the enzyme that dissolves hyaluronic acid and emergency equipment. These elements, often invisible to the patient, are part of the quality of care; do not hesitate to ask about them.

To judge a practitioner's results, look at photos taken under the same conditions before and after: the same light, the same angle, the same expression, without make-up or filters. Light from above deepens dark circles; light from the front erases them. Be wary of photos taken just after treatment, when swelling gives an illusion of taut skin. Results after several months are the most reliable.

To understand the limitations and risks of a treatment near the eyes, it is important to communicate in a language you master. In French-speaking Switzerland, consultations take place in French; in the major German-speaking cities, many practitioners see patients in French or English; in Ticino, in Italian. Ask for a written instruction sheet in your language.

After each treatment, ask for written instructions: care to apply, things to avoid, warning signs and the number to call. They are particularly useful after a laser or plasma treatment, whose care lasts several days. If your language is not that of the practice, ask for a version in your language or bring someone who can translate.

• 1. Identify what really bothers you: skin, hollows, dark circles, bags, eyebrow.
• 2. Consult a practitioner who will be able to tell you whether surgery is preferable.
• 3. Understand the limitations, duration and cumulative cost of medical treatments.
• 4. Start with a measured, often reversible procedure.
• 5. Assess, adjust, and reconsider surgery if the results are not enough.

• Observing what bothers you, photos without filters.
• First opinion, possibly from photos.
• Consultation: diagnosis, medical or surgical guidance, plan and quote.
• Period of reflection.
• First treatment, often the simplest or a reversible one.
• Check-up and adjustment.
• Maintenance plan or referral for surgery if necessary.

A second opinion is useful if you are offered an expensive programme of several sessions, if you are hesitating between medical treatment and surgery, or if previous treatments have disappointed you. Bring your photos, the list of products already used and your questions. A practitioner who refers you for surgery, or advises against a treatment, is no less competent than another: they are often more honest.

Before any treatment, the practitioner must inform you of its principle, the expected results and their duration, the risks, the alternatives, including surgical ones, and the cost. For injections around the eyes, the information must mention the rare risk of vascular complications. Take the time to read the documents and ask your questions. You can withdraw at any time.

Oculoplastic surgeons are ophthalmologists or plastic surgeons specialising in the eyelids, tear ducts and orbit. They are particularly familiar with the anatomy of the area and the interactions between aesthetics and eye function. Their opinion is invaluable when you are hesitating between medical treatment and surgery, or when you have dry eyes, previous eyelid surgery or a complication after an injection.

Many also perform injections and medical treatments of the eye area, with an overall view of the eyes.

The dermatologist is the skin specialist. They are particularly competent for pigmented dark circles, dark marks, fine lines, skin quality, lasers and peels, as well as for skin diseases of the eyelids, such as eczema, rosacea or certain lesions to be monitored. A small eyelid lesion that grows, bleeds or causes lashes to fall out must always be examined by a dermatologist.

Eye treatment often involves several professionals: a dermatologist for the skin, a plastic surgeon or oculoplastic surgeon for the structure, sometimes an ophthalmologist for dry eyes or an eye examination, and a family doctor for general health questions. Good communication between them, and a file that follows you with the list of products and procedures performed, ensure that the plan is coherent.

Medical treatments are often presented as quick and simple, which encourages quick decisions. Nevertheless, take time to understand what is being offered, especially for under-eye injections and programmes of several sessions. A reputable practitioner lets you think it over, answers all your questions and does not push you to have the treatment on the day of the first consultation.

The following table positions the treatments relative to one another, taking as a base of 100 a hyaluronic acid session for the tear trough. It also allows the cumulative cost of maintenance over several years to be compared with that of surgery.

Over several years, maintenance treatments can end up costing as much as surgery, for a more limited result. This calculation helps with the choice. Details by city on our page on medical blepharoplasty prices in Switzerland. These cosmetic treatments are not covered by basic insurance.

As medical treatments are temporary, it is useful to think over several years. A botulinum toxin session three times a year, a tear trough injection every year and a few laser or skin-quality injectable sessions represent an annual budget which, over five or ten years, can exceed that of a surgical blepharoplasty. Conversely, for someone whose eyes show little laxity, a few spaced sessions are enough.

Discuss a realistic plan suited to your budget with the practitioner, rather than multiplying sessions on a whim.

For someone who regularly maintains their eyes with botulinum toxin, hyaluronic acid and skin-quality sessions, the cumulative budget over ten years can reach or even exceed that of a surgical blepharoplasty, whose effect on excess skin and bags lasts many years. This calculation is not a reason to choose surgery if it is not indicated, but it is worth doing when hesitating between the two approaches.

Surgery does not always remove the need for complementary medical treatments, particularly for skin quality and crow's feet. But it often reduces their frequency. The practitioner can help you make this comparison based on your situation.

• Tear trough: the hollow groove between the lower eyelid and the cheek.
• Bag: bulging of orbital fat under the eyelid.
• Crow's feet: wrinkles at the outer corner of the eye.
• Hyaluronic acid: a resorbable injectable gel.
• Hyaluronidase: an enzyme that dissolves hyaluronic acid.
• Plasma: a device that tightens the skin through micro-discharges.
• Radiofrequency: deep heating of the skin that stimulates collagen.
• Fractional laser: a laser that treats the skin in micro-columns.
• Tyndall effect: a bluish tinge due to a gel placed too superficially.

• Medical blepharoplasty improves skin, hollows and wrinkles, without removing skin or fat.
• Fat bags and pronounced excess skin call for surgery.
• Under-eye injections require a very experienced practitioner.
• The effects are temporary and require maintenance.
• The sun must be avoided after surface treatments.
• An accurate diagnosis of the eyes is the first step.

Medical treatments of the eye area refresh the eyes with few constraints, provided their indications and limitations are respected. The best approach starts with an honest diagnosis: what is due to skin, volume, muscle or fat. It continues with an experienced practitioner, measured procedures and regular sun protection. And it remains open to surgery when that will give a better result.

A more rested look is within reach of many people thanks to medical treatments, provided the indication is right. The right treatment depends on the cause: skin, volume, muscle or fat. Measured procedures, performed by an experienced practitioner and combined with a healthy lifestyle and sun protection, give the most natural and lasting results. And when surgery is more appropriate, accepting it is often the wisest decision, for a clear and lasting result that avoids years of successive touch-ups.

Medespoir Suisse helps you find out whether medical treatment or surgery is best suited to your eyes, understand the options and their limitations, and find a qualified practitioner in your region and your language.

Medical treatments of the eye area offer worthwhile solutions to refresh the eyes and soften hollows, dark circles or fine lines, with little or no downtime. They do, however, have limitations and do not replace blepharoplasty when there is excess skin or fat. The key to a good result is an honest diagnosis, a practitioner experienced in this delicate area and realistic expectations. To find out more, see our pages on blepharoplasty and on laser blepharoplasty.

Budget

Price differences between cities and cantons, the quote breakdown and ways to save are detailed on our page Medical blepharoplasty: prices in Switzerland.

Related procedures

• Laser blepharoplasty in Switzerland
• Fox eyes in Switzerland
• Genioplasty in Switzerland
• Facial fat transfer in Switzerland
• Ethnic rhinoplasty in Switzerland

Our guides

• Blepharoplasty in Switzerland
• Cosmetic surgery in Switzerland

Answers to the most frequent questions about non-surgical eye treatments. For surgery, see our page on blepharoplasty in Switzerland.

Understanding the treatments

What is medical blepharoplasty? This term refers to all the non-surgical treatments that improve the appearance of the eyelids and eye area: hyaluronic acid injections, botulinum toxin, plasma, radiofrequency, lasers, peels and skin-hydrating injectables. The term is a marketing one: it is not a blepharoplasty in the surgical sense, as no skin or fat is removed. These treatments act on skin quality, volume and the position of the tissues.

Does it replace surgical blepharoplasty? No, not when excess skin or fat bags are significant. Medical treatments can improve thin, wrinkled skin, fill a hollow or slightly lift the eyebrow, but they do not remove skin hanging over the lashes or a fat herniation. They are suited to early signs or to people who do not want surgery, accepting a more modest result.

Does hyaluronic acid get rid of bags? No. Hyaluronic acid does not remove the fat from bags. Injected into the hollow below the bag, it can soften the transition between the bag and the cheek, making it less visible. When the bag is large, the injection may instead accentuate it or create swelling. In this case, a lower blepharoplasty is generally more appropriate.

What is the tear trough? It is the hollow groove that runs from the inner corner of the eye and slopes down towards the cheek. It deepens with age, loss of volume and sometimes genetics, and gives a tired look, even after a good night's sleep. It can be softened with hyaluronic acid or fat injections, performed by an experienced practitioner, as the area is delicate.

Does botulinum toxin open up the eyes? Yes, moderately. By relaxing the muscle fibres that pull the tail of the eyebrow down, it allows it to lift by a few millimetres, which slightly opens up the eyes. It also softens crow's feet. It does not correct significant excess skin or bags. The effect lasts about three to four months.

What is plasma? Plasma is a device that produces a small electric arc between its tip and the skin, without contact, creating tiny points of vaporisation on the surface. As it heals, the skin contracts slightly. Used on the upper eyelid, it can tighten a very moderate excess of skin. It leaves small crusts for about a week and requires precautions, particularly on olive skin.

Can plasma replace upper blepharoplasty? Only for very slight laxity. Plasma tightens the skin a little, but the effect is limited and varies from person to person; it does not remove fat and does not correct pronounced excess skin. Several sessions are often needed. For excess skin that hangs over the lashes or obstructs vision, surgery remains the most effective solution.

What is radiofrequency? Radiofrequency heats the deep layers of the skin without damaging its surface, which stimulates collagen production and leads to slight, gradual firming. Around the eyes, suitable devices allow comfortable sessions with little or no downtime. Results are modest and appear over several months; several sessions are generally needed.

Are surface lasers useful? Yes, for skin quality. Fractional or resurfacing lasers soften fine lines, improve texture and can slightly tighten the thin skin of the eyelids. They require strict eye protection and cause redness or crusts for a few days, depending on their intensity. They do not correct bags or significant excess skin. See our page on laser blepharoplasty.

Are peels suitable for the eyelids? Light, specific peels can improve radiance, fine lines and some pigmentation around the eyes. They must be performed with products suited to this very thin skin and close to the eyes, by a trained professional. Deeper peels around the eyes carry risks of pigmentation and scarring, particularly on olive skin.

What is a skin-hydrating injectable? These are products based on lightly cross-linked hyaluronic acid, sometimes combined with other molecules, injected in small quantities into the skin to improve its hydration and elasticity. Around the eyes, they can soften fine lines and give a fresher appearance. Their effect is gradual, requires several sessions and remains modest.

Are eye creams effective? They moisturise the skin and can slightly soften the appearance of fine lines and dark circles, particularly those containing gentle retinoids, vitamin C or caffeine. They have no effect on fat bags, excess skin or a pronounced hollow. Daily sun protection remains the most useful care for the skin around the eyes.

Can several treatments be combined? Yes, and this is often the most effective approach: for example, botulinum toxin for crow's feet and the tail of the eyebrow, hyaluronic acid for the tear trough, and laser or radiofrequency for skin quality. Sessions are planned in a logical order and spaced out, to limit side effects and judge the effect of each treatment.

How many sessions are needed? It depends on the technique: one session for botulinum toxin, repeated every three to four months; one or two sessions for hyaluronic acid; often two to four spaced sessions for plasma, radiofrequency, fractional lasers or skin-hydrating injectables. The practitioner draws up a plan suited to your skin and goals.

Are the effects immediate? Hyaluronic acid gives an immediate effect, which becomes more refined once the swelling has resolved. Botulinum toxin acts within a few days, with a maximum effect at two weeks. Plasma, radiofrequency and lasers act gradually, over several weeks to a few months, as the skin produces collagen.

How long do the effects last? Botulinum toxin lasts three to four months, hyaluronic acid in the tear trough often six to twelve months, sometimes longer. The effects of plasma, radiofrequency and lasers on skin quality can last one to two years, but ageing continues. Regular maintenance is generally necessary.

Are the treatments painful? They are generally well tolerated. Injections are given with very fine needles or cannulas, often with an anaesthetic built into the product or an anaesthetic cream. Plasma and some lasers cause a prickling or warm sensation, reduced by an anaesthetic cream. Radiofrequency gives a sensation of warmth.

Is there any downtime? After botulinum toxin, none. After hyaluronic acid, slight swelling and sometimes a bruise for a few days. After plasma, small crusts for about a week. After a laser, redness for a few days, longer for powerful lasers. After radiofrequency, redness for a few hours.

Are thread lifts used for the eyelids? Not directly on the eyelids, whose skin is too thin. Threads can be placed in the temple area to slightly lift the tail of the eyebrow, with a moderate and temporary effect. See our page on fox eyes, which details these techniques and their limitations.

Is medical blepharoplasty safer than surgery? It is less invasive and recovery is quicker, but it is not risk-free. Injections around the eyes can, rarely, cause serious complications, such as blockage of an artery. Lasers and plasma can leave dark marks or scars. Safety depends mainly on the practitioner's qualifications and on choosing the right indication.

Who they are for and how to choose

At what age can treatment start? There is no strict minimum age for skincare, but injectable treatments are generally discussed from the thirties onwards, when signs of tiredness or ageing appear. In younger people, hereditary dark circles or bags may justify a consultation, but caution is needed before any procedure.

My bags are hereditary: is medical treatment enough? Rarely. Hereditary bags are due to fat bulging under the lower eyelid, sometimes from the twenties. Injections can sometimes soften the transition with the cheek if the bags are modest, but they do not eliminate them. A lower blepharoplasty, often through an internal approach with no visible scar, gives a much clearer and more lasting result.

I have dark circles: which treatment? It depends on the cause. Pigmented dark circles, common on olive skin, respond to lightening creams, gentle peels or certain lasers, with caution. Vascular dark circles, bluish in colour, are linked to thin skin through which blood vessels show; they sometimes improve with injectables that thicken the skin. Hollow dark circles respond to hyaluronic acid. An accurate diagnosis is essential.

I have excess skin that obstructs my vision: what should I do? In this case, medical treatments are not enough. Excess skin of the upper eyelid that hangs over the lashes and reduces the visual field calls for surgical blepharoplasty, which may be covered by insurance if the impairment is documented by a visual field test. Consult a plastic surgeon or a specialist ophthalmologist.

Are men concerned? Yes, more and more men seek advice for tired-looking eyes, dark circles or crow's feet. Treatments are adapted to preserve a masculine appearance: measured doses of botulinum toxin, cautious injections, and care not to feminise the eyes by lifting the eyebrow too much.

Can olive skin be treated? Yes, with precautions. Olive and dark skin carries a higher risk of brown marks after a laser, plasma or peel. The practitioner chooses suitable techniques and settings, sometimes prepares the skin with creams, and recommends strict sun protection. Injections and botulinum toxin pose no particular problem.

Can I be treated during pregnancy? No. As a precaution, injections, botulinum toxin, lasers, plasma and peels are postponed during pregnancy and breastfeeding. A moisturiser and sun protection remain possible. It is advisable to wait until breastfeeding has ended.

Are dry eyes a contraindication? Not necessarily for injections and botulinum toxin, but significant dryness should be mentioned, as some treatments, such as toxin around the eye, can slightly change it. For lasers and plasma close to the eye, dryness can be temporarily worsened. Treating the dryness before the sessions improves comfort.

I have already had a blepharoplasty: can I have these treatments? Yes, often. Medical treatments can complement surgery: improving skin quality, filling a tear trough or softening persistent fine lines. The practitioner takes account of the scars and changes in anatomy. Bring the report of your procedure.

Who can perform injections in Switzerland? Botulinum toxin and hyaluronic acid injections are medical procedures, performed by doctors, particularly dermatologists, plastic surgeons, trained aesthetic doctors or ophthalmologists specialising in oculoplastics. Injections around the eyes require particular experience because of the thinness of the tissues and the proximity of important blood vessels.

How do I recognise a good practitioner for this area? A good practitioner first checks whether you need surgery, explains the limitations of medical treatments honestly, knows the vascular anatomy of the eye area, has the enzyme that dissolves hyaluronic acid and an emergency protocol, and shows you real results. Check their title in the MedReg register.

Are low prices a trap? A very low price should prompt you to check the practitioner's qualifications, the origin of the products, the quantity injected and what is included, such as check-ups and touch-ups. Injections around the eyes are delicate procedures; savings must not come at the expense of safety.

Is a consultation needed beforehand? Yes, always. It identifies the cause of what bothers you — bags, excess skin, hollows, pigmented dark circles, wrinkles — determines whether medical treatment is suitable or whether surgery is preferable, and establishes a plan and a quote. No treatment should be carried out without this assessment.

Can I get an opinion from photos? Yes, a first opinion can be given from front, profile and three-quarter photos taken in daylight, without make-up, looking straight ahead and then upwards. It helps decide between medical treatment and surgery. The final decision requires an in-person consultation.

Are these treatments reimbursed? No, medical cosmetic treatments of the eye area are at the patient's expense. Only certain medical situations, such as surgical blepharoplasty justified by documented visual impairment, may be covered by insurance.

Does the result look natural? With measured doses and the right indication, yes. The risk of an artificial look comes mainly from too much hyaluronic acid under the eyes, which creates swelling or a bluish tinge, or from too much botulinum toxin, which freezes the eyes. A cautious practitioner prefers to complete the treatment in two sessions rather than do too much at once.

Can hyaluronic acid be dissolved? Yes. An enzyme, hyaluronidase, dissolves hyaluronic acid within a few hours to a few days. It is used to correct an excess, persistent swelling or a bluish tinge, or in an emergency in the event of a vascular complication. This is a major argument for using only hyaluronic acid, and never permanent products, around the eyes.

Which season should I choose? For lasers, plasma and peels, autumn and winter are preferable, as sun exposure after these treatments increases the risk of dark marks. For injections and botulinum toxin, the season matters little, but avoid scheduling a session just before a sunny holiday or an important event.

How much does maintenance cost over several years? As medical treatments are temporary, their cost adds up: botulinum toxin several times a year, hyaluronic acid every six to eighteen months, periodic laser or radiofrequency sessions. Over several years, the cumulative budget can approach that of a surgical blepharoplasty, whose effect lasts longer. This is a factor to take into account in the decision.

Can I have a treatment before an important event? Yes, by planning ahead: botulinum toxin at least two to three weeks before, hyaluronic acid two to three weeks before to allow swelling and bruising to settle, and lasers and plasma a month or more before, depending on their intensity. Avoid any new treatment in the week before the event.

Procedure and recovery

How is an injection under the eyes performed? After cleaning and disinfecting the skin, sometimes with an anaesthetic cream, the practitioner injects hyaluronic acid in small amounts, often deep against the bone, with a needle or cannula. They gently mould the product and check the result with you sitting up. The session lasts about thirty minutes.

Needle or cannula? Both are used. The cannula, with its rounded tip, glides between the tissues and reduces the risk of bruising and injury to a blood vessel; it is often preferred for the tear trough. The needle allows very precise placement against the bone. The choice depends on the area, the anatomy and the practitioner's experience.

What should I do after an injection? Apply cold through a cloth if swelling appears, avoid massaging the area unless instructed, sleep with your head slightly raised the first night, and avoid intense sport, the sauna, alcohol and exposure to heat for twenty-four to forty-eight hours. Report any intense pain or change in skin colour immediately.

What should I do after botulinum toxin? Stay upright for about four hours, do not massage the injected area and avoid intense sport, the sauna and steam rooms on the same day. You can resume your usual activities immediately. The effect appears within a few days and is judged at two weeks.

What should I do after plasma? Small crusts form; do not scratch them and let them fall off on their own, in about a week. Clean gently according to the instructions, apply the prescribed cream and avoid make-up on the area while the crusts are present. Strict sun protection is essential for several weeks to avoid dark marks.

What should I do after a laser? Depending on the intensity, the skin is red, sometimes oozing or crusty for a few days. Moisturise generously with the prescribed cream, avoid make-up until healed, do not rub, and strictly protect the skin from the sun for several weeks. Preventive treatment against cold sores may be prescribed.

When can I wear make-up? After botulinum toxin, a few hours later. After hyaluronic acid, the next day, avoiding massaging the area. After plasma or a laser, only once the skin has healed, often after seven to ten days. Use clean or new products.

When can I do sport? After botulinum toxin, the next day. After hyaluronic acid, after twenty-four to forty-eight hours. After plasma or a laser, once the skin has healed, avoiding excessive sweating and swimming pools during healing.

Is a touch-up planned? Often, a check-up at two to four weeks allows adjustments: extra botulinum toxin or hyaluronic acid if necessary. For plasma and lasers, several sessions are generally planned from the outset. Ask about touch-up conditions before the treatment.

Is bruising common? Around the eyes, the skin is thin and rich in small blood vessels, which makes bruising more common after injections, especially with a needle. Bruises disappear within a few days to two weeks. Stopping certain medicines and supplements, on medical advice, and using a cannula reduce this risk.

How long does a session last? A botulinum toxin session takes about fifteen minutes, a hyaluronic acid injection thirty minutes, a radiofrequency session thirty to sixty minutes, and a plasma or laser session thirty to sixty minutes, including any time for an anaesthetic cream to take effect.

Can I go back to work immediately? After botulinum toxin, radiofrequency and often hyaluronic acid, yes. After plasma or a laser, most patients prefer to wait a few days for crusts and redness to fade, especially if they are in contact with the public.

Are sunglasses useful? Yes. They protect the treated skin from the sun, hide small bruises or crusts and protect the eyes from bright light. After a laser or plasma treatment, choose wraparound glasses and combine them with a suitable sunscreen.

Can I wear contact lenses? After injections and botulinum toxin, yes, avoiding pulling on the treated skin when inserting them. After a laser or plasma treatment close to the eye, it is better to wear glasses for a few days while the skin heals.

Should I avoid the sauna? Yes, for at least forty-eight hours after injections and botulinum toxin, and until healing is complete after plasma or a laser. Heat increases swelling and may encourage certain complications.

When can the result of radiofrequency be seen? Slight tightening may be felt just after the session, but the real effect, linked to collagen production, appears gradually over two to six months. Several sessions a few weeks apart strengthen the result.

Is the result of plasma visible straight away? No. Just after the session, the skin is marked with small dots and slightly swollen. The tightening appears after the crusts have fallen off and continues for a few weeks. The final result is often judged after two to three months.

Do the results need maintaining? Yes. The effects of botulinum toxin and hyaluronic acid are temporary, and the skin continues to age. Regular maintenance, combined with daily sun protection and suitable skincare, prolongs the results.

What if I do not like the result? Talk to the practitioner at the check-up. Excess hyaluronic acid can be dissolved, the effect of botulinum toxin fades within a few months, and adjustments are often possible. If the result remains disappointing, a second opinion can be useful, particularly to find out whether surgery would be more appropriate.

Can these treatments prepare for future surgery? They do not prepare for it as such, but improving skin quality with laser or skincare before a blepharoplasty can contribute to a better overall result. However, repeated hyaluronic acid injections under the eyes must be mentioned to the surgeon, as they can alter the tissues.

Risks and safety

Are injections around the eyes dangerous? They are safe in experienced hands, but the area contains blood vessels connected to the circulation of the eye. Very rarely, an injection into a blood vessel can cause skin compromise or damage to vision. That is why these injections must be performed by trained doctors who know the anatomy and have an emergency protocol.

Which signs should alert me after an injection? Intense, unusual pain, pale, purplish or mottled skin, any visual disturbance, even temporary, spreading redness, fever or discharge. In these cases, contact the practitioner immediately or go to the emergency department, stating which product was injected.

What is the bluish tinge? When hyaluronic acid is injected too superficially under thin skin, it can show through as a bluish tint, called the Tyndall effect. It is not dangerous, but it is unsightly. It is corrected with the enzyme that dissolves the product.

Can swelling persist? After an injection under the eyes, slight swelling is normal for a few days. In some people, particularly those prone to morning bags, hyaluronic acid can retain water and cause persistent swelling. It can be corrected by dissolving the product. That is why the tear trough is treated with small quantities.

Can botulinum toxin make the eyelid droop? Rarely, if the product spreads to the muscle that lifts the upper eyelid, temporary drooping of the eyelid can occur. It disappears within a few weeks and can be reduced with specific eye drops. A precise technique and following the post-injection instructions reduce this risk.

Can plasma leave marks? Yes. Brown or light patches, small dot-like scars or prolonged redness can appear, especially on olive skin, with sun exposure or if the crusts are picked off. The choice of settings, strict sun protection and following the care instructions limit these risks.

Can a laser burn the skin? With inappropriate settings or on skin that has not been prepared, a laser can cause a burn, scars or changes in pigmentation. These complications are rare with an experienced practitioner who adapts the parameters to the skin and protects the eyes with specific shields.

Can you be allergic to the products? True allergies to hyaluronic acid or botulinum toxin are rare. Local or delayed inflammatory reactions can occur. Mention any allergy, particularly to local anaesthetics, and any history of reactions after an injection.

Are nodules possible? Yes, small lumps can appear after a hyaluronic acid injection, due to an accumulation of product or an inflammatory reaction, sometimes months later. They are treated by massage, with the enzyme that dissolves the product or with other treatments depending on their cause.

Are infections common? No, they are rare thanks to disinfection and hygiene conditions. Redness, warmth, increasing pain or discharge require prompt medical attention. After a laser or plasma treatment, good hygiene and following the care instructions limit the risk of infection of the small wounds.

Can cold sores flare up? Yes. In people prone to cold sores, a laser, plasma or peel can trigger an outbreak. Preventive antiviral treatment is often prescribed. If you have an active cold sore, the treatment is postponed.

Can the treatments damage the eye? The eye must be protected with suitable shields during laser treatments, and devices used near the eyelids must be handled with care. Injections carry an exceptional risk of damage to vision in the event of a vascular complication. These risks justify choosing a qualified, properly equipped practitioner.

Are products of unknown origin a risk? Yes, a significant one. Unauthorised products, bought online or injected by people who are not doctors, may be contaminated, wrongly dosed or contain permanent substances. They expose you to infections, nodules and deformities that are difficult to treat. Insist on knowing the product name and its batch number.

What should I do in the event of a complication? Contact the practitioner who performed the treatment immediately. In the event of visual disturbance, intense pain or a change in skin colour after an injection, and if the practitioner cannot be reached, go to the emergency department. Keep the information about the product used.

Does smoking affect the results? Yes. Smoking accelerates ageing of the skin around the eyes, shortens the duration of treatment effects and slows healing after a laser or plasma treatment. Stopping smoking improves skin quality and results.

Are complications covered? As cosmetic treatments are at the patient's expense, coverage of their complications depends on the situation and may remain at your expense. Ask the practitioner about the conditions for managing complications and touch-ups, and check with your insurer.

Can these treatments be done with an autoimmune disease? Some autoimmune or inflammatory diseases and certain immunosuppressive treatments increase the risk of reactions to injections or poor healing after a laser. Treatment is possible in some cases, during a stable period, after discussion with the doctor managing the disease.

Are anticoagulants a problem? They increase the risk of bruising after injections. They must never be stopped without the prescribing doctor's advice. The practitioner can adapt their technique, for example by using a cannula, and warn you of the risk of more marked bruising.

Whom should I contact in an emergency? The practitioner who performed the treatment, whose number you will have noted, including outside opening hours. In the event of visual disturbance or if the practitioner cannot be reached, go to the emergency department, ideally at a hospital with an ophthalmology department, or call 144.

How can the risks be reduced? Choose a qualified doctor experienced in the eye area, check that they have the enzyme and an emergency protocol, mention your medical history and treatments, accept measured doses, follow the instructions after treatment, protect yourself from the sun, and seek advice without delay if anything unusual occurs.

Organising your treatment in Switzerland

Where can these treatments be done in Switzerland? Injections and botulinum toxin are offered by dermatologists, plastic surgeons and aesthetic doctors in most towns. Lasers, plasma and radiofrequency are available in many dermatology and aesthetic medicine practices, especially in the major cities, notably Geneva, Lausanne, Bern, Basel, Zurich, Lucerne and Lugano.

How much does a treatment cost? The cost varies according to the technique and the amount of product: botulinum toxin is the least expensive per session, hyaluronic acid and laser or plasma sessions are in the middle, and programmes of several sessions represent a larger budget. We express this in relative indices on our price page.

Is it reimbursed? No, these treatments are cosmetic and at the patient's expense. Supplementary insurance generally does not cover them either. Only eyelid surgery justified by documented visual impairment may be covered.

Do I need to take time off? After botulinum toxin and most injections, no. After plasma or a laser, allow a few days of discretion, especially if you are in contact with the public. Schedule these sessions before a weekend if possible.

What should the quote specify? The technique, the name and quantity of the product or the planned settings, the number of sessions, the practitioner, the location, the check-ups and touch-ups included, and the period of validity. A clear quote allows offers to be compared.

Should I compare several practitioners? It is useful, especially for a programme of several sessions. Compare the quality of the analysis of your eyes, how cautious the proposals are, the ability to refer you for surgery if necessary, the products used and the content of the quotes.

Can I be treated in my own language? In French-speaking Switzerland, consultations are held in French. In the major German-speaking cities, many practitioners see patients in French or English; in Ticino, in Italian. Ask when booking.

What if I live far from a major city? Injections and botulinum toxin are available in most regions. For lasers and plasma, you sometimes need to travel to a larger town. Group the sessions together and ask whether some check-ups can be done using photos.

Should I keep documents? Yes: the name and batch of the products injected, the doses of botulinum toxin, the laser settings, the dates of the sessions and before-and-after photos. This information is invaluable for later sessions, in the event of a complication or before surgery.

How can I get a personalised opinion? You can send us photos of your eyes and a few words about what bothers you. We will direct you to a suitable practitioner, medical or surgical, in your region and your language. Free and without obligation.

Are waiting times long? For botulinum toxin and injections, an appointment is often possible within a few days to a few weeks. For lasers, plasma or a programme of several sessions, planning takes place over several weeks.

Can my family doctor refer me? Yes, they can refer you to a dermatologist, plastic surgeon or ophthalmologist, particularly if the problem has a medical dimension, such as dry eyes, allergies or visual impairment. They can also advise you on managing your treatments.

Can an ophthalmologist perform these treatments? Some ophthalmologists specialising in eyelid surgery, called oculoplastic surgeons, also perform injections and medical treatments of the eye area. Their knowledge of the eye and eyelids is an asset, particularly for assessing whether surgery would be preferable.

Can these treatments be done in a pharmacy or beauty salon? Botulinum toxin and hyaluronic acid injections must be performed by a doctor. Beauty salons can offer surface treatments, massages or non-medical devices, whose effects are limited. Medical lasers and plasma must be used by trained professionals in a medical setting.

Are treatments possible in winter? Yes, winter is even the best season for lasers, plasma and peels, as the sun is less intense. Beware, however, of reflection off the snow: sun protection and sunglasses remain essential in the mountains.

Should I avoid skiing after a treatment? After botulinum toxin and injections, skiing is possible after a few days, with good sun protection. After a laser or plasma treatment, you must wait until healing is complete and avoid intense mountain sun for several weeks, because of the risk of dark marks.

Can medical treatment be combined with surgery? Yes. Medical treatments often complement a blepharoplasty: botulinum toxin for crow's feet, laser for skin quality, injections for the tear trough. They can be performed before or a few months after surgery, according to the plan.

How do I know whether I need surgery? If the skin of the upper eyelid hangs over the lashes, if fat bags are clearly visible all the time, or if successive medical treatments have not satisfied you, surgery is probably more appropriate. An honest practitioner will tell you so at the consultation.

Are the results the same for everyone? No. They depend on age, skin quality, the extent of the signs to be treated, genetics, lifestyle and individual response to treatment. That is why a personalised plan and realistic expectations are essential.

Can I stop the treatments? Yes, at any time. The effects gradually disappear and the face returns to its natural course, with no rebound effect. Stopping does not damage the skin; only excessive repeated treatments could have altered the tissues, hence the value of measured doses.

Send us photographs — front view with eyes open and then closed, profile and close-ups, in natural light. We will tell you whether your eyes call for medical treatment or surgery, and what budget to plan for. Free and without obligation.