Rothwell Classification of AI and Internet Search Results in Blepharoplasty Related Queries

Patients increasingly turn to online search engines and artificial intelligence (AI) tools to gather information about blepharoplasty, yet the accuracy and reliability of these sources remain uncertain. In this study, ten blepharoplasty-related search terms were entered into Google Chrome using a standardized, depersonalized browser. For each term, the Google Gemini AI-generated response and the top 50 "People Also Ask" (PAA) questions were collected. Questions were categorized using the Rothwell classification system and subcategorized by topic. Most questions were fact-based (53%), with technical details (25.6%) and cost (18.6%) being the most frequent subtopics. The majority of linked webpages originated from single-surgeon or medical practice sites (39.0% and 24.7%), which demonstrated the lowest average JAMA scores (1.67 and 1.83). In contrast, peer-reviewed journals and academic sources achieved the highest JAMA scores but were rarely represented among results. Google Gemini responses predominantly referenced academic sources (60%) and achieved higher average JAMA scores (2.40) than webpages retrieved through PAA. Overall, online blepharoplasty information is highly variable and frequently falls short of established standards for authorship, attribution, and reliability. Although AI-generated responses demonstrated superior quality compared with traditional search results, inconsistencies in source citation remain a concern. These findings highlight the ongoing need for quality oversight of online medical content and suggest that, when properly regulated, AI tools may serve as valuable adjuncts in patient education.