October 11, 2026 | Blepharoplasty, Facial Procedures, Plastic Surgery News
The first thing anybody looks at when they see somebody is their eyes. I think that’s what gives us an overall feeling about the patient, and it is the first thing that we will form an opinion on.
The International Society of Aesthetic Plastic Surgery just published its survey of procedures performed in 2025. Eyelid surgery is number one in the world, ahead of liposuction. 2,457,677 operations, up 16.2 percent in one year and 69.9 percent since 2021.
| Face and head, worldwide 2025 | Procedures | Change vs 2024 | Change vs 2021 |
|---|---|---|---|
| Eyelid surgery | 2,457,677 | plus 16.2% | plus 69.9% |
| Rhinoplasty | 1,015,685 | minus 6.3% | plus 2.1% |
| Fat grafting to the face | 944,410 | minus 0.3% | plus 60.2% |
| Facelift | 738,945 | plus 0.3% | plus 54.7% |
| Brow lift | 647,725 | plus 23.5% | plus 123.3% |
| Neck lift | 540,449 | plus 13.2% | plus 85.8% |
| Hyaluronic acid filler (non-surgical) | 4,737,957 | minus 25.2% | minus 10.3% |
Source: ISAPS International Survey on Aesthetic/Cosmetic Procedures Performed in 2025. China leads with 306,000 eyelid operations; the United States did 137,684. Men are 22.3 percent of eyelid patients worldwide, 548,407 of them, which makes it the most common surgery men have.
Why Patients Come In
I think the most common reason patients come in is because people are telling them that they look tired, when they’re actually feeling just fine and feel like they have energy. A lot of them feel younger than their actual age, but the eyelids are not helping them send this message out. They look in the mirror and they look at photos, and they can identify the areas that they don’t like.
Blepharoplasty is really a procedure that patients are very happy with. It is a predictable procedure. It takes care of the complaints that patients have, which is the excess upper eyelid skin with hooding, and even difficulty putting on makeup, the skin resting on the eyelids, and the overall look of appearing tired. In the lower eyelids, they usually complain of also looking tired, with the bags under their eyes, which may be worse in the mornings, and the tear trough deformity.
Why Filler Lost and Surgery Won
The same survey has hyaluronic acid filler down a quarter in a year. Under the eyes, I have been moving away from it for a while.
Fillers over time have started to come out of favor, as we are now noticing that the filler really never dissolves. The results can last about a year, but the filler does not dissolve, it just disperses. I have seen cases where it blocks the lymphatic drainage, and patients start having bags under the eyes, which are worse in the mornings, or they have discoloration or lumpiness.
Patients with festoons, thin skin, and true fat herniation are not the greatest candidates for fillers under the eyes. Fat is one of the procedures we perform when treating the periorbital area, and just adding volume to the tear trough can hide the under-eye bags for a while. But as they keep progressing, it comes to a point where adding volume is not going to help, and we actually need to remove those herniated fat pads.
Upper, Lower, or Both
Upper eyelids versus lower eyelids. Most patients come in for one or the other, but they may actually benefit from working on both. I think the lower eyelids are a lot more common, with people complaining about their lower eyelid bags, and these are maybe slightly younger patients. The older patients are definitely concerned about their upper eyelids, the hooding, and even the visual impairment it’s causing.
The brow lift numbers in the survey, up 23.5 percent in a year and more than doubled since 2021, belong in the same conversation. A heavy brow and hooded upper lids are often the same complaint, and the consultation sorts out which one is doing the work.
The Older Patient
I’m actually not surprised that patients sixty-six and older grew by the most percentage compared to any other age bracket. I think patients are becoming a lot more willing to undergo facial procedures, including facelifts, because the results now are actually natural and do not change their overall appearance. So they still have a self identity after these procedures and they’re recognizable; they’re just looking ten to fifteen years younger.
There’s not an ultimate age where I would say no. It really depends on how the patient presents themselves, what their desires are, whether these are results that we can deliver, and most importantly, that they have medical clearance, that they’re healthy, that any medical conditions they have are well controlled, that they’re fit for a recovery, and that they have the support necessary to get through it.
Recovery
The recovery for eyelid surgery is actually quite easy. In my experience with patients, we usually don’t have any pain, but there will be swelling, and there could be bruising around the eyes. If there’s bruising, it can take one to two weeks for the bruising to go down. The upper lid does have a visible scar, which heals quite quickly, and the sutures are absorbable. The lower eyelid surgery does not have any visible scars. Most patients return to work after a week using a little bit of makeup to cover any bruising if necessary.
The procedures to fix these complaints are usually short, can be performed under local anesthesia or even IV sedation, and have short recovery times. This is of course noticed by people around them very quickly, and that’s how word of mouth spreads, and this procedure keeps becoming one of the most common that we perform.
Why Choose Dr. Agullo
I am certified by the American Board of Plastic Surgery and the American Board of Surgery, trained in plastic surgery at the Mayo Clinic, and teach as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly has named me a Top Doctor every year from 2014 through 2026. Eyelid surgery, with and without a brow lift and fat grafting, is one of the procedures I perform most.
Ready to Talk?
Call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation at agulloplasticsurgery.com/appointments. Pricing is on the fees page. #StayBeautiful
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