Decoding the Digital Discourse: A Thematic and Sentiment Analysis of Reddit Posts on Eyelid Surgery

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 To characterize emotions, language use, and patient priorities in Reddit discussions about eyelid surgery. Methods We performed a cross-sectional mixed-methods analysis of English-language posts and top-level comments from eight subreddits (May 12, 2024–May 12, 2025). A transformer-based model and the National Research Council (NRC) Emotion Lexicon were used to assign sentiment polarity and discrete emotions and to quantify post–comment 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 We analyzed 1,579 posts and 3,576 top-level comments. Posts demonstrated mixed sentiment polarity (39.0% positive, 32.2% negative, 28.8% neutral), whereas comments were more often positive (55.8%) than negative (24.1%) or neutral (20.1%). Across post–comment pairs (one pair per comment), 64.5% were discordant, most commonly negative-post → positive-comment. Fear and sadness predominated in posts, while trust and anticipation were more common in comments. Medical terminology appeared frequently yet was often imprecise. Thematic analysis yielded nine 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.