BACKGROUND: Asian blepharoplasty, or double eyelid surgery, is widely accepted among Asians
however, personal and cultural influences on patient satisfaction remain underexplored. This study examines the sociocultural and psychological factors shaping patient-reported outcomes through qualitative and quantitative analyses. METHODS: This mixed-methods study included 40 Asian-identifying women recruited via social media and community events. Qualitative interviews were analyzed using NVivo for thematic analysis, word frequency, and node matrix comparisons, with cross-tabulation to explore relationships between themes (e.g., motivations and cultural normalization) and demographics. Participants completed the FACE-Q Satisfaction with Eyes subscale
linear regression was used to assess association of satisfaction with age and ethnicity. RESULTS: Overall, 86% viewed blepharoplasty as culturally normalized, especially in Korean and Chinese communities. Personal motivations were central, with 76% citing enhanced symmetry, confidence, and makeup ease as the primary reasons. Satisfaction was high, with 89% appreciating a "natural" look, though 10% had minor regrets about the crease shape. Social support was strong (81%), largely from family and friends. Quantitatively, FACE-Q satisfaction scores averaged 24.45 ± 1.91, with a range of 22 to 28, reflecting consistently high satisfaction levels across participants. Common terms included "natural" (65 mentions), "confidence" (58), and "supportive" (48), underscoring the value placed on aesthetic and social acceptance. CONCLUSION: The study highlights the deeply personal motivations for blepharoplasty and cultural normalization within Asian communities. Age-based satisfaction differences suggest tailored counseling, with findings affirming the centrality of personal choice in surgical decisions. Future research should further examine long-term psychosocial impacts to optimize patient-centered care.