Abstract
BACKGROUND: Eyelid surgery is among the most performed aesthetic and functional procedures, yet existing patient-reported outcome measures may miss unprompted concerns voiced on social media. OBJECTIVES: The aim of this study was to characterize emotions, language use, and patient priorities in Reddit discussions about eyelid surgery. METHODS: The authors performed a cross-sectional mixed-methods analysis of English-language posts and top-level comments from 8 subreddits (May 12, 2024 to May 12, 2025). A transformer-based model and the National Research Council Emotion Lexicon were used to assign sentiment polarity and discrete emotions and to quantify postcomment concordance. Sociolinguistic features (lexical richness, readability, and medical terminology density) were computed for all entries. A random sample of 500 entries underwent inductive thematic analysis. RESULTS: The authors analyzed 1579 posts and 3576 top-level comments. Posts demonstrated mixed sentiment polarity (39.0% positive, 32.2% negative, and 28.8% neutral), whereas comments were more often positive (55.8%) than negative (24.1%) or neutral (20.1%). Across postcomment pairs (1 pair per comment), 64.5% were discordant, most commonly negative post → positive comment. Fear and sadness predominated in posts, whereas trust and anticipation were more common in comments. Medical terminology appeared frequently yet was often imprecise. Thematic analysis yielded 9 themes, including preoperative anxiety, dissatisfaction despite acceptable results, distress over mild asymmetry, and social-media-driven surgeon selection. CONCLUSIONS: Reddit discourse reveals clinically literate but diagnostically uncertain patients who judge success by culturally inflected, photo-salient aesthetics and rely on peer reassurance. Early vocabulary alignment and explicit counseling on asymmetry and variability may improve expectation setting and generate testable hypotheses for counseling strategies.