Differences in Gaze Patterns for Facial Areas of the Asian Human Face between Female Patients Undergoing Upper Blepharoplasty and Nonoperators: An Eye-Tracking Analysis

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.We hypothesized that postblepharoplasty 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.Case-control study (STROBE guidelines) comparing 20 females who underwent upper blepharoplasty alone with 20 nonoperated controls.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.Patients after upper blepharoplasty alone showed longer eye fixation (male: <i>p</i> = 0.03; female: <i>p</i> = 0.041) and faster female eye fixation (<i>p</i> = 0.029). Male forehead fixation increased (<i>p</i> = 0.004). Other regions showed no difference.Blepharoplasty modifies visual attention, potentially reflecting postsurgical self-perception changes. Findings suggest cosmetic procedures may influence social cognition.