Preferences for the ocular region aesthetics and elective double eyelid surgery in Chinese: A nationwide discrete choice experiment.

Abstract

This study aimed to investigate preferences for elective double eyelid surgery and explore the psychosocial underpinnings influencing ocular aesthetics and attitudes toward aesthetic surgery. This nationwide online experiment was conducted throughout four tiers of cities in China using quota sampling, which included self-administered Likert scales for general self-efficacy and modified body image and a set of discrete choice experiments (DCE) that measured the relative value and odds ratio of elective double eyelid surgery surgical options and marginal willingness to pay for procedure attributes. A total of 554 respondents were included in the final analysis (41.9% males and 57.9% females). A total of 47.1% of the respondents perceive double eyelid surgery as acceptable, with surgeon proficiency being the most important attribute (25.88%), followed by healthcare facilities (17.90%), maintenance time of double eyelid (18.62%), and others. Respondents held a Juste-milieu and moderate mind for ocular aesthetics. Those who accepted the surgery had higher ratings on all items of the modified body-image measures than their counterparts, with the sum of the 5-point Likert values being 27.5 (SD 11.2) versus 21.2 (SD 10.0) (P < 0.001 for all), whereas there were no differences in the general self-efficacy scale. Chinese respondents prioritized improving their physical appearance and preferred undergoing aesthetic double eyelid surgery with a skilled surgeon at a higher-tier hospital. Understanding patients' stated preferences, training new surgeons, and improving Chinese medical system facilities are vital and urgent to better balance patient expectations and improve aesthetic surgical satisfaction.