For years, the rhinoplasty and the facelift were the procedures that dominated conversations about cosmetic surgery. Both have been pushed aside. The most requested operation in aesthetic clinics from Los Angeles to London, and increasingly across the Asia-Pacific, is now a far subtler intervention: blepharoplasty, or surgery on the eyelids, a roughly $3,000 outpatient procedure that clinicians say patients are seeking in unprecedented numbers.
Two-thirds of facial plastic surgeons report a rise in demand, according to a survey by the American Academy of Facial Plastic and Reconstructive Surgery. “Patients increasingly want to look refreshed rather than transformed,” explained the academy’s president, Dr Anthony Brissett.
Blepharoplasties now sit among the three most common facial plastic surgeries, alongside nose jobs and facelifts, and rank fifth on the most recent list of cosmetic procedures overall.
A surge that has gone global
The figures are striking. Roughly 119,000 people in the United States underwent the procedure in 2025, according to the American Society of Plastic Surgeons, a 19 per cent increase on 2024.
The fastest-growing cohort is not the one most people would guess.
Adults over 45 still account for the largest share of procedures in absolute terms. But the steepest year-on-year percentage rise has been among patients aged 25 and under.
That shift has not gone unnoticed in the Asia-Pacific, a region that has for two decades been one of the world’s most active markets for aesthetic surgery. Clinics in Seoul, Tokyo, Bangkok and Singapore have long treated eyelid surgery as a routine, socially unremarkable enhancement rather than a dramatic intervention, and the “refreshed, not transformed” philosophy that Western surgeons are now articulating has been standard practice in many Asian clinics for years. What has changed is the volume, the age of the patients and the speed with which the trend is travelling.
Social media, celebrity and the Ozempic effect
Three forces are driving the boom, and they are reinforcing one another.
The first is social media, which has collapsed the distance between seeing a result and wanting it. “With social media, people get excited and they think, ‘OK, I’m just going to swipe right and I’m going to look like this,'” Dr C. Bob Basu, a past president of the American Society of Plastic Surgeons, told The New York Times.
The second is celebrity candour. Over the past two years, a series of high-profile figures have discussed their own procedures with unusual openness, removing much of the stigma that once surrounded cosmetic surgery.
Olympic gold medallist Simone Biles, 29, told People last November that she had undergone a lower blepharoplasty. “I got a lower bleph because me and my family have, I call it the ‘Biles eye bags,'” she said. “We’ve just always had them, hereditary, and so that was just a big flaw.”
The actress Denise Richards, 55, told Allure in March that she had wanted to “put things back up, where they were before”. She added: “Being in the public eye since my 20s, people know what I look like — a facelift is not something that I could hide.”
Nickelodeon star Amanda Bynes, meanwhile, told NBC’s TODAY that her 2023 blepharoplasty “was one of the best things I could’ve ever done for my self-confidence, and it made me feel a lot better in my skin”.
The third driver is pharmacological. The widespread uptake of GLP-1 weight-loss drugs has produced a widely discussed side effect: rapid fat loss in the face, leaving a hollowed, aged appearance that has been nicknamed “Ozempic face”. Patients who have lost significant weight are increasingly arriving at clinics asking for the volume around their eyes to be restored.
What the surgery involves, and what it risks
Blepharoplasty is generally performed under local anaesthetic, with the patient awake. Surgeons remove excess skin, and sometimes fat, from the upper or lower eyelids. The operation typically takes a few hours and is carried out as an outpatient procedure.
It is widely regarded as safe when performed with appropriate planning and aftercare. But it is still surgery, and it carries genuine risks.
Common side effects include bruising, swelling and dry eyes, with visible swelling and bruising usually persisting for the first few weeks. Rarer but more serious complications include scarring, infection, injury to the eye muscles, bleeding and, in uncommon cases, problems with vision, according to the Mayo Clinic and the Cleveland Clinic. Most patients recover at home over the course of a couple of months, and many return to normal routines within a week or two.
Not everyone is a suitable candidate. Columbia University’s Irving Medical Center advises that patients with conditions such as high blood pressure, thyroid disease, diabetes or cardiovascular disease may face elevated surgical risk and should be assessed carefully beforehand.
Cost is another consideration. In the US, only blepharoplasties performed to correct vision obscured by drooping skin are typically covered by health insurance. Cosmetic procedures are paid for out of pocket, at a price point that has become a meaningful barrier for younger patients.
The expectations problem
Surgeons are united on one point that rarely makes it into before-and-after photographs: the procedure refreshes rather than reinvents.
“You shouldn’t expect the surgery to drastically change your look,” the Cleveland Clinic advises. “It’s important to know your face well before you decide to have surgery. Think carefully about your expectations and discuss them with your surgeon.”
There is also a practical caveat. Because ageing continues after the operation, many patients require more than one blepharoplasty over their lifetime. The procedure is better understood as maintenance than as a permanent fix.
For a demographic that has grown up comparing their faces to filtered images, that distinction matters more than it might appear.
Why it Matters
The rise of the “bleph” is a case study in how aesthetic medicine is changing shape. The era of the dramatic, transformative makeover is giving way to something quieter and more commercial: subtle procedures, marketed as maintenance, sold to patients who want to look rested rather than different. That shift is being driven by platforms that reward comparison, by celebrities who have destigmatised the conversation, and by a weight-loss drug boom that has created an entirely new category of patient. For the Asia-Pacific, long a global centre of eyelid surgery, the trend is less an arrival than an acceleration, and it brings familiar questions into sharper focus. Regulation of who may practise cosmetic surgery remains uneven across the region, and the medical risks, though modest, are real. The deeper issue is not surgical but psychological: as these procedures become as routine as a dental appointment, the challenge for clinicians, and for regulators, is ensuring that patients arrive with sound expectations and sound motives, not simply a phone full of filtered faces.