Body image and acceptance of cosmetic surgery in China and the Netherlands: A qualitative study on cultural differences and similarities

Genital Cosmetic Surgery in Women of Different Generations: A Qualitative Study

BACKGROUND

Individuals from different generations are interacting more and more today, and while each generation exists with its own characteristics, this situation causes intergenerational differences in every issue in social life. Considering the characteristics of different generations, it is predicted that individuals' views on genital cosmetic surgery may differ.

OBJECTIVE

This study was conducted to examine the views of women of different generations on genital cosmetic surgery and to determine their perspectives on genital cosmetic surgery.

METHODS

The population of the study consists of women from different generations. The sample of the study was formed using typical case sampling from purposive sampling methods. Data saturation was reached by conducting qualitative interviews with 15 women by selecting the snowball sampling method. Data were collected using a semi-structured individual interview form, and data analysis was performed using MAXQDA 2020.

RESULTS

The opinions of women of different generations about genital cosmetic surgery were analysed under four themes and 13 categories as "Perception of Beauty", "Perception of Health", "Perception of Society" and "Perception of Need". The opinions of women of different generations about genital cosmetic surgery differ. It is thought that these differences may be caused by factors such as psychosocial, economic, environment, media, technological developments and culture. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Examining body appreciation in six countries: The impact of age and sociocultural pressure

Previous research on body appreciation across the lifespan has produced conflicting results that it increases with age, decreases with age, or is generally stable with an increase in women over 50-years-old. Furthermore, most of the research has been conducted in White, Western populations. Cross-cultural research suggests that both Chinese and African women experience similar sociocultural pressures as White Western women, and that appearance ideals are shifting to resemble a more Western ideal. We cross-sectionally and cross-culturally examined body appreciation across the lifespan, recruiting White Western women (UK, USA, Canada, and Australia), Black Nigerian women, and Chinese women. 1186 women aged 18-80 completed measures of body appreciation, internalisation of thin and athletic ideals, and perceived sociocultural pressure. Body appreciation did not vary with age in women from any country. Nigerian women reported the highest body appreciation, and Western women the lowest. Higher thin/athletic ideal internalisation, and higher perceived sociocultural pressure were significantly associated with lower body appreciation in all countries and age-groups. Overall, our findings indicate that although levels of body appreciation differ drastically between ethnicities and cultures, it is generally stable across age, and shows cross-culturally robust relationships between sociocultural internalisation and pressure.

Beauty ideals and body positivity: a qualitative investigation of young women's perspectives on social media content in China

Much of the existing knowledge regarding the impact of beauty ideals and body positive social media content on women's body image is based on the Western cultural context. This limits our understanding of the issue in other cultures, such as China, among others. Therefore, to address this gap, this study examined young Chinese women's perspectives on beauty ideals and body positivity in social media through a qualitative investigation. Female university students in China (N = 24) participated in individual interviews. A thematic analysis revealed four primary themes: (1) characteristics of mainstream beauty ideals in Chinese social media; (2) impact of beauty ideals on young women; (3) perspectives on the content and roles of body positivity; (4) influences of body positive social media content on young women. These findings indicate that young Chinese women are aware of the beauty ideals in social media and their negative impact on their body image. Furthermore, young Chinese women generally expressed a favorable outlook on body positivity but noted its limitations.

Impact of Gender-Role Attitudes and Mental Health on Hostile Sexism and Acceptance of Cosmetic Surgery

BACKGROUND

Each year, tens of thousands of people worldwide choose to undergo cosmetic surgery in order to alter their appearance. In recent years, young people have gradually emerged to comprise the main driving force behind the increasing demand for cosmetic surgery. Previous studies have found that sexism may motivate young people to undergo such surgeries. However, few studies have been conducted to determine if this psychological mechanism influences the acceptance of cosmetic surgery among Chinese university students.

METHODS

A total of 579 Chinese university students (280 girls and 299 boys, 17-20 years) volunteered to participate in the online survey. They completed a questionnaire containing the Ambivalent Sexism Inventory, the 12-item General Health Questionnaire, the Gender-Role Attitudes Questionnaire and the Acceptance of Cosmetic Surgery Scale. We firstly evaluated the underlying factor structure of the Acceptance of Cosmetic Surgery Scale using exploratory and confirmatory factor analyses, and exploring pattern of associations between the constructs was analyzed via path analysis.

RESULTS

According to the findings, hostile sexism was associated with greater levels of acceptance toward cosmetic surgery. Moreover, gender-role attitudes mediated the link between hostile sexism and the acceptance of cosmetic surgery, and this mediation was positively influenced by general mental health.

CONCLUSION

Our study contributes to a deeper understanding of Chinese university students' attitudes toward cosmetic surgery, hostile sexism may contribute to normalizing traditional gender stereotypes and encourage cosmetic surgery acceptability among Chinese university students.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Effect of Beautification Strategies on Mating Popularity Judged by Men from the People's Republic of China

Contemporary women frequently employ beautification strategies. The impact of such strategies, such as plastic surgery, on mating popularity in different mate contexts remains unclear. To investigate this issue, the current study conducted two experiments. In Experiment 1, beautification strategies were manipulated using three images of the same female with different conditions (natural, makeup, and plastic surgery). The results indicated that when the beautification strategies were not informed, surgical-enhanced and makeup targets were perceived as significantly more attractive, loyal, and popular among potential mates than natural targets. However, when participants were informed of the beautification strategies, both natural and makeup targets showed a significant increase in perceived loyalty and mating popularity. In contrast, surgically enhanced targets saw a reduction in these dimensions. Experiment 2 aimed to reduce the confounding effect of facial attractiveness by using vignettes. The results indicated that the mating popularity of natural targets was significantly higher than that of makeup or surgically enhanced targets, with surgically enhanced targets being the least popular. Moreover, the results revealed the mediating role of perceived loyalty in the impact of beautification strategies on long-term mating popularity. This study sheds light on the potential stigmatization and negative bias toward beautification strategies in the mating market. Additionally, it provides guidance for women who intend to enhance their mate popularity through plastic surgery.

Pathways from media attention and peer communication to body dissatisfaction: the moderating role of protective filtering

BACKGROUND

Negative body image is a common psychological phenomenon among young Chinese women, and merits further investigation. Peers and the media are important factors that associated with body image. This study explored how media and peers promote body dissatisfaction among young Chinese women, including the mediating role of body surveillance and the moderating role of protective filtering.

METHODS

3499 women from the general China community aged 18-40 years (M = 23.44 years, SD = 1.18 years) were investigated with sociocultural attitudes towards appearance scale-3, objectified body consciousness scale and protective filtering scale. The data were analyzed by using a moderated mediation model with SPSS and the Process 4.0 macro.

RESULTS

Correlational analysis results indicated that body surveillance acted as a chained indirect effect between the internalization of media information and body dissatisfaction, as well as between peer comparison and body dissatisfaction. Moreover, protective filtering was demonstrated to moderate the path of media attention affecting the internalization of media information and the path of peer communication affecting peer comparisons.

CONCLUSION

Our results contribute to the understanding of the sociocultural mechanisms underlying young women's negative body image. Furthermore, investigating the moderating effect of protective filtering is conducive to guiding future female positive body image interventions.

The relationship between personality traits and willingness to undergo cosmetic surgery in the non-clinical population - a systematic review and meta-analysis

Objective

Conducting a systematic review and meta-analysis to synthesize previously obtained results regarding the relationship between interest in cosmetic surgery and personality traits.

Methodology

A series of criteria were applied (at the level of design, independent variables, dependent variable, participants) in order to decide which existing studies could be considered eligible for inclusion in the meta-analytic procedure. The identification of research that met the eligibility criteria was carried out with the help of the electronic search function in the following databases: ScienceDirect, PsycInfo, Web of Science, Scopus, Springer, and PubMed. Following this approach left 13 studies that were then subjected to the final analysis and included in the meta-analysis.

Results

The researchers' expectations were partially supported by the results of the analyses, thus demonstrating the existence of a significant relationship between perfectionism (socially prescribed perfectionism; perfectionistic self-promotion), appearance-based rejection sensitivity, and interest in pursuing esthetic surgery.

Discussions

Identifying these relationships will allow cosmetic surgeons to understand both the mechanisms underlying this decision and the need for psychological assessment/counseling before patients undergo such procedures. It will also allow psychologists to develop best practice guidelines for how they relate to the patient before they perform cosmetic surgery. At the same time, psychotherapists will be able to devise targeted and personalized interventions for each personality profile, so that the decision to undergo an esthetic operation is not made based on a dispositional trait (fear of rejection, stress caused by body dissatisfaction).

Body image interventions within breast cancer care: A systematic review and concept analysis

There needs to be a consensus regarding the definition of body image in oncology the literature. This lack of agreement leads to conflicting results in psychosocial interventions aimed to improve body image among breast cancer patients. Through an instrumentalist approach, this systematic review aims to analyze how body image as a concept is described and operationalized in breast cancer studies with the focus to enhance body image through psychosocial interventions. Databases were searched in October 2022 and updated in February 2023 to find empirical studies reporting psychosocial intervention targeting body image efficacy. The results from 24 studies show many similarities and differences between the definitions (e.g. characteristics) and questionnaires (e.g. Cronbach's alpha coefficient) used to evaluate this concept. Most definitions include thoughts, feelings, and behaviors related to body image. Finally, the psychosocial implications are discussed. This systematic review is registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022326393).

Selfie behavior and cosmetic surgery consideration in adolescents: the mediating roles of physical appearance comparisons and facial appearance concern

Selfie activity may contribute to the acceptance of cosmetic surgery in adolescents, although few empirical studies exist. Based on social comparison theory, this study examined the association between selfie behavior and cosmetic surgery consideration among Chinese adolescents and further tested the possible mediating roles of social comparison and facial appearance concern in this relationship. A sample of 537 adolescents (339 girls and 198 boys) were recruited voluntarily to complete questionnaires on selfie behavior, upward physical appearance comparison, facial appearance concern and cosmetic surgery consideration. Linear regression and mediation analyses were conducted. The results showed that selfie behavior predicted higher level of adolescents' cosmetic surgery consideration. Moreover, this relationship was sequentially mediated through upward physical appearance comparison and facial appearance concern. These findings expand the existent literature by suggesting that selfie behavior may trigger upward social comparison in adolescents, which in turn increase their acceptance of cosmetic surgery.

The Health Impacts, Prevalence, and Acceptance Level of Cosmetics Interventions Among Females in Saudi Arabia

Background

With the rising global desire for beauty, cosmetic interventions have increased. Saudi Arabia ranked 29 among the top 30 fastest growing countries for cosmetic procedures.

Objectives

This study aims to investigate the prevalence, acceptance level, and health impacts of cosmetic interventions among females in Saudi Arabia.

Methods

This cross-sectional study was conducted from December 2022 to January 2023 among females living in Saudi Arabia. Participants' acceptance of cosmetic interventions was assessed using an Arabic version of the validated Acceptance of Cosmetic Surgery Scale. The data were collected using a self-administered questionnaire.

Results

The study included 3007 females living in Saudi Arabia. About 58% of the participants were aged 18 to 25, and 72.9% were single. The prevalence of cosmetic interventions among the participants was 10%. A higher prevalence was observed among participants over 25 years, married, high economic status, employed, postgraduate, and participants recognizing the necessity of cosmetic interventions (P < .001). High acceptance levels toward cosmetic interventions were observed among older, married, employed, and postgraduate respondents and those with high economic status (P < .001). Meanwhile, knowing the adverse events of cosmetic interventions was associated with a low level of acceptance with a P-value of <.001.

Conclusions

The present study demonstrated a surprising prevalence of cosmetic interventions among females in Saudi Arabia. However, below-average acceptance of these interventions among the same population was reported. This could be a result of the surrounding culture that does not support or encourage undergoing cosmetic interventions. Further studies are recommended to assess the prevalence of those interventions using objective tools, such as medical records.

Level of Evidence 4

Cosmetic Surgery and the Diversity of Cultural and Ethnic Perceptions of Facial, Breast, and Gluteal Aesthetics in Women: A Comprehensive Review

An increasing number of people are opting for cosmetic surgeries. For many years, the physical and aesthetic appearance of Caucasians has been considered to be ideal. However, it is now commonly acknowledged that attractiveness and aesthetic standards vary among cultural backgrounds and ethnic groups and that Western attractiveness criteria no longer apply to all. Herein, we conducted a comprehensive review of studies that examined cultural and ethnic variations in preferences for facial, breast, and gluteal aesthetics, as well as reviewed studies that investigated ethnic disparities in attitudes and motivations for cosmetic surgery. A total of 4532 references were identified, 66 of which met the inclusion criteria. Several studies have reported that facial golden ratios are invalid for representing perceived attractiveness standards among different ethnicities. The majority of studies also indicated that facial aesthetic interventions should not aim to Westernize but to optimize ethnic traits. Significant ethnic differences in preferences for upper- and lower-pole breast proportions have been reported. The size of the buttocks and waist-to-hip ratio were identified as the main factors of buttock aesthetics, with buttock size preferences having a high ethnic diversity. Interest in cosmetic surgical procedures while maintaining ethnic identity continues to grow among young women worldwide. This comprehensive review strongly suggests that accommodating cultural and ethnic differences in aesthetic standards in cosmetic surgery planning can lead to more acceptable cosmetic outcomes.

Social media, traditional media, and other body image influences and disordered eating and cosmetic procedures in Malaysia, Singapore, Thailand, and Hong Kong

In this study, we investigated the association between perceived sociocultural influences and the 3-month prevalence of disordered weight-control behaviors and lifetime prevalence of cosmetic procedures in four Asian countries, and if these associations were modified by gender. We conducted a cross-sectional online survey in September 2020 among adults ages 18-91 years (N = 5294) in Malaysia, Singapore, Thailand and Hong Kong. The 3-month prevalence of disordered weight control behaviors ranged from 25.2 % (Singapore) to 42.3 % (Malaysia), while the lifetime prevalence of cosmetic procedures ranged from 8.7 % (Singapore) to 21.3 % (Thailand). Participants who perceived their body image to be influenced by sociocultural factors were more likely to engage in disordered weight control behaviors (RRs ranged from 2.05 to 2.12) and have cosmetic procedures (RRs ranged from 2.91 to 3.89) compared to participants who perceived no sociocultural influence. Men who were influenced by traditional or social media were more likely to engage in disordered weight control behaviors and have cosmetic procedures than similarly influenced women. The high 3-month prevalence of disordered weight control behaviors and lifetime prevalence of cosmetic procedures in Asia is concerning. More research is needed to develop effective preventive interventions in Asia for men and women to promote a healthy body image.

Consumers' body image expressions: Reflection of a Snow White or an Evil Queen

Introduction

The aim of this paper is to explore how minimal-self impacts the body image, projecting it as a reflection of one's approach toward their health and mental well-being.

Methods

The study takes qualitative data from two countries India and Germany and draws on a qualitative study of 20 individuals who are involved in some kind of physical activity for a long time. This paper examines the body image perspectives from Grimms Brothers fairytale characters showcasing fit and healthy perspectives on Snow White side and projected and superfluous perspectives on Evil Queen side. The study also provides a model deciphering the rationale for both the reflections.

Results

The body image projection from Snow White perspectives (success &amp; dedication, self-esteem, bodybuilding, and cosmetic surgery) relates to positive reflection of oneself with focus on fitness, discipline, and mental rejuvenation in life. Notably, Evil Queen perspectives (unrealistic makeover, dark side of social media, gain an edge over others, and mental benchmarking with fair skin) reveal these facets as motivators to equip their body as means of physical non-verbal communication assets.

Conclusion

Analysis shows that there is no clear white or black view of health and fitness projection via body image but it's a gray line that gives wholesome fitness either a holistic mental peace or a competitive or success-oriented approach.

Towards a better understanding of the social stigma of facial difference

Facial difference (FD) is not only an individual experience; it is inherently social, reflecting interactions between social norms and individual attitudes. Often FD is stigmatized. In this paper, we employ a widely used stigma framework, namely the social stigma framework put forth by Pryor and Reeder (2011), to unpack the stigma of FD. This framework posits that there are four forms of stigma: public stigma, self-stigma, stigma by association, and structural stigma. We first discuss the social and psychological literature on FD as it pertains to these various forms of stigma. We then describe coping approaches for FD stigma. Lastly, we delineate evidence-based methods for addressing the various forms of FD stigma, such that future efforts can more effectively tackle the stigma of facial difference.

"We should educate the public that cosmetic procedures are as safe as normal medicine": Understanding corporate social responsibility from the perspective of the cosmetic procedures industry

The cosmetic procedures industry is profitable and expanding. Through its premise and promotion, the industry contributes to unrealistic societal appearance pressures considered harmful to body image. In the context of limited regulation, there is an uneasy reliance on businesses in the sector to act in a socially responsible way. Corporate social responsibility (CSR) refers to voluntary business practices designed to benefit society, and engagement in CSR is shaped by extrinsic and intrinsic drivers. This study aimed to explore how senior UK industry professionals view CSR as it applies to their sector and to body image. Findings from 14 semi-structured interviews show that participants' understanding of CSR was limited to a myopic focus on patients. Little reflexivity was demonstrated in relation to the industry's responsibilities concerning negative body image in society. More broadly, the drivers of socially responsible practice were overwhelmingly extrinsic - oftentimes explicitly linked to bolstering or protecting company and/ or industry reputation. Participants, acknowledging a lack of intrinsic motivation for CSR across the sector, were largely in support of greater regulation. This research contributes to understandings of how the adoption of a CSR agenda might combine with regulatory efforts to curb the industry's impact on negative body image.

Photo Activity on Social Networking Sites and Body Dissatisfaction: The Roles of Thin-Ideal Internalization and Body Appreciation

Objective: According to sociocultural theory, media is associated with detrimental effects on body image. Due to the popularity of social networking sites (SNS) and the prevalence of body image disturbance among young women, the association between them is worth further exploration. This study examined the relationship between photo activity on SNS and body dissatisfaction (BD) and the roles of thin-ideal internalization (TII) and body appreciation (BA) in this relation. Materials and Methods: A total of 746 Chinese female undergraduate students (mean age 20.34 ± 1.47 years) completed a questionnaire measuring SNS photo activity, TII, BD, and BA. Results: (1) Photo activity on SNS was positively associated with BD (r = 0.10, p < 0.01), and TII could mediate this relation (β = 0.07, 95% CI = [0.04, 0.10]). (2) Both the direct effect of SNS photo activity on BD (β = −0.08, p < 0.05) and the mediating effect of TII (β = −0.09, p < 0.01) were moderated by BA. Specifically, these associations were more pronounced for students with lower BA. Conclusion: People exposed to ideal photos or images can shape women’s body image perception via TII, whether in the age of traditional media or the Internet, and BA did not buffer the effect of ideal photos on internalization. Our findings could provide practical suggestions for rational photo activity on SNS and the intervention for BD.

Australian women's motivations for, and experiences of, cosmetic surgery: A qualitative investigation

Little qualitative literature has examined women's motivations for undergoing cosmetic surgery or their experiences throughout the surgery process (e.g., consultation, aftercare, and recovery). To fill this gap, we interviewed 15 Australian women (M_age = 37.67) who had undergone cosmetic surgery. We conducted a reflexive thematic analysis from which we generated five overarching themes. Broadly, participants described the 'cosmetic surgery lifestyle' as being normalised in contemporary Australian society. In terms of their own cosmetic surgery experiences, several expressed suffering from severe depression immediately post-surgery. Most participants also discussed how interactions with other people influenced their cosmetic surgery journeys. For instance, several described having problematic and/or distressing interactions with cosmetic surgeons, while others spoke to the lack of emotional support they received from romantic partners. Finally, almost all participants described how cosmetic surgery was a decision they made 'for themselves' (i.e., completely independent of external influence), yet, paradoxically, described how negative comments made by others drove them to cosmetic surgery. These findings contribute to existing feminist accounts of cosmetic surgery and highlight ethical concerns regarding how cosmetic surgery is practiced in Australia.