BACKGROUND: People often have high expectations for blepharoplasty, and patient complaints can serve as a valuable tool to understand their specific requirements and desired outcomes. OBJECTIVES: The objective of this study was to analyze blepharoplasty complaints and identify patient concerns regarding postoperative effects, surgical difficulties, and potential pitfalls. METHODS: A retrospective analysis of 138 complaints related to blepharoplasty was conducted. We documented demographic information and complaints details, and compared the reason of complaints between primary and revision double eyelid operations. RESULTS: In this study, primary double eyelid operation was found to have the highest number of complaints. "Asymmetry" is the most frequent cause of dissatisfaction in both primary and revision double eyelid surgeries, and "asymmetric crease height" accounted for the majority of complaints in this category. Compared with primary double eyelid operation, revision double eyelid operation was more likely to be complained for "asymmetric crease shape", and the difference was statistically significant (p <
0.05). The most common reasons for complaints following lower blepharoplasty, epicanthoplasty, and eyebrow lift procedures were "incomplete resection of under-eye puffiness", "asymmetry", and "upper eyelid laxity", respectively. Compared to lower blepharoplasty and eyebrow lift, primary and revision double eyelid surgeries as well as epicanthoplasty are more prone to complaints of "asymmetry". In contrast, compared to primary double eyelid operation, epicanthoplasty is more likely to result in complaints of "noticeable scarring". CONCLUSIONS: Complaints regarding blepharoplasty can reflect patients' expectations and requirements, as well as the challenges and pitfalls of the surgical procedure. This information can assist physicians in enhancing their comprehension of patients' needs and paying closer attention to the difficulties and potential complications associated with surgery.