# Global Surveillance of Public Interest in Cosmetic Tourism for Aesthetic Eyelid Surgery Abroad: Cross-Sectional Infodemiology Investigation of Internet Search Trends and Social Media Content

## TL;DR

The study examines American interest in eyelid surgery abroad and finds that international surgeons often lack specialized training compared to US surgeons.

## Contribution

This is the first global infodemiology study to analyze cosmetic eyelid surgery tourism trends and surgeon qualifications via digital data.

## Key findings

- Top eyelid surgery destinations for Americans include South Korea, Mexico, Canada, Turkey, and China.
- International eyelid surgeons are more likely to be general plastic surgeons without specialized fellowship training.
- US surgeons have higher rates of professional society affiliations compared to international surgeons.

## Abstract

Global medical tourism for aesthetic surgery has become a popular phenomenon through ease of access in the digital era, though such services are not without potential risks. The application of infodemiology for global health surveillance may provide unique insights into unknown patient travel patterns and surgeon workforce dynamics abroad.

This study aimed to evaluate American cosmetic tourism trends in oculofacial plastic surgery, including demand profile and qualifications of the most sought-after international eyelid surgeons on social media.

This cross-sectional infodemiology study queried Google Trends to assess US interests in aesthetic eyelid surgery abroad in 25 destination countries from 2013 to 2023. The highest-rated content posted by 55 eyelid surgeons (US: n=11; international: n=44) on a social media platform (Instagram; Meta Platforms) was evaluated. The main outcomes included Google search volumes for aesthetic eyelid surgery for each destination country, as well as specialty training and professional medical society affiliations of popular eyelid surgeons on social media in each of these countries.

The top 5 destinations Americans sought for aesthetic eyelid surgery abroad were South Korea, Mexico, Canada, Turkey, and China. Interest in eyelid surgery abroad remained stable over the last decade despite 118% growth in blepharoplasty searches. Social media indicated eyelid surgeons abroad were more often general plastic surgeons than in the United States (30/44, 68% vs 2/11, 18%; P=.003). US surgeons more frequently completed oculofacial plastics, facial plastics, or aesthetic plastics fellowships compared with international surgeons (9/11, 82% vs 10/44, 23%; P<.001) and had membership in professional medical societies (11/11, 100% vs 22/44, 50%; P=.002).

American demand for international eyelid surgery remained stable over the past decade despite a 2-fold increase in the US interest for blepharoplasty. Digital epidemiology data reveal a shortage of international surgeons with specialized aesthetic eyelid fellowship training or professional society affiliations on social media among the preferred destinations for Americans seeking aesthetic eyelid surgery. These findings may provide beneficial insights for patients interested in traveling abroad for eyelid surgery, as well as for surgeons or academic societies seeking to increase social media presence or patient-directed educational content via social media engagement.