Differences in gaze patterns for facial areas of the Asian human face between female patients undergoing upper blepharoplasty and non-operators: an eye-tracking analysis

Introduction Blepharoplasty's psychological effects are well-studied, but its impact on social cognition, particularly gaze behavior, remains unexplored. Understanding how cosmetic surgery alters visual attention to faces has implications for patient counseling and social interaction research. Objectives & Hypotheses We hypothesized that post-blepharoplasty patients would exhibit altered gaze patterns, specifically increased attention to eyes due to heightened self-awareness. Primary outcomes were fixation duration and time to first fixation on facial regions. Study Design Case-control study (STROBE guidelines) comparing 20 females who underwent upper blepharoplasty alone with 20 non-operated controls. Methods Participants viewed standardized AI-generated Asian faces while eye-tracking recorded fixation metrics. ANOVA compared groups (IRB-approved). AI was used solely for image generation. Results Patients after upper blepharoplasty alone showed longer eye fixation (male: p=0.03; female: p=0.041) and faster female eye fixation (p=0.029). Male forehead fixation increased (p=0.004). Other regions showed no difference. Conclusions Blepharoplasty modifies visual attention, potentially reflecting post-surgical self-perception changes. Findings suggest cosmetic procedures may influence social cognition. Keywords: upper blepharoplasty, eye-tracking, visual attention, facial perception Acknowledgements: AI generated facial stimuli only; no AI writing tools were used.

Publication History

Received: 28 March 2025

Accepted after revision: 15 April 2025

Accepted Manuscript online:
16 April 2025