Eyelid surgery is the most performed aesthetic operation in the world. The International Society of Aesthetic Plastic Surgery counted 2,457,677 of them in 2025, up 16.2 percent in a year and 69.9 percent since 2021. It beat liposuction. One in five patients was a man.
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. So a lot of patients are self aware of these features, and they come in to get them resolved.
“You Look Tired”
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. Sometimes they can’t really identify exactly which procedures they need, and of course that’s why we’re there, to help them come up with the best plan possible.
Why the Syringe Lost
The same survey has filler down 25 percent in a year. Under the eyes I saw that coming.
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. Sometimes they can also get inflamed. So I have dissolved a lot of under-eye fillers in order to improve all these complications, and that is why I am more inclined to use fat rather than hyaluronic acid fillers.
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.
Why It Keeps Winning
The procedures to fix these complaints are usually short, can be performed under local anesthesia or even IV sedation, and have short recovery times. Patients can return to work fast and they heal fast as well, so they see an overall transformation and are quite happy with the results. 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.
Some patients actually return to work earlier and use thick-rimmed glasses to kind of hide the surgical aspect.
The upper-versus-lower question, the brow lift numbers and the older patient are in the full post on the Agullo Plastic Surgery site.
Why Me
Double board-certified, Mayo Clinic trained, Clinical Associate Professor of Plastic Surgery at Texas Tech, Castle Connolly Top Doctor 2014 through 2026. Eyelids are one of the operations I do most, and the one patients thank me for fastest.
Ready to Talk?
Call (915) 590-7900, text 1-866-814-0038, or book online. #StayBeautiful
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