Materialism, Sociocultural Appearance Messages, and Paternal Attitudes Predict College Women's Attitudes About Cosmetic Surgery

Greater Risk Taking in Cosmetic Surgery Acceptance and History: An Experimental and Computational Study

Cosmetic surgery is ever more affordable and accessible, but carries physical and psychological risks. Yet, no study to date has directly examined risk-taking behaviour under controlled conditions, beyond self-report and in relation to cosmetic surgery attitudes. We used the Balloon Analogue Risk Task and advanced computational modelling to measure decision-making behaviour and identify the latent parameters driving behaviour associated with cosmetic surgery attitudes in women with no cosmetic surgery history (N = 265) and a subsample of women with a cosmetic surgery history (N = 24). Risk taking was higher in women with greater acceptance and history of cosmetic surgery. Computational modelling revealed increased risk taking in women with greater acceptance of cosmetic surgery when decisions were made with greater knowledge of loss (risk) and not when the likelihood of loss was unknown (uncertainty). When women with greater acceptance of cosmetic surgery made decisions, they also placed less emphasis on possible losses (reduced loss aversion). Our findings suggest that women seeking cosmetic procedures may be less sensitive to losses and thus make more risky decisions. Greater emphasis should be placed on communicating potential losses rather than just the associated risks to women considering cosmetic procedures.No Level Assigned This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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 .

Factors Associated with Likelihood to Undergo Cosmetic Surgical Procedures Among Young Adults in the United States: A Narrative Review

Introduction/Goals

Over the past decade, cosmetic surgical procedures have become increasingly popular. This trend has been driven by procedural innovations as well as access to Internet and social media. Consequently, patients have been seeking cosmetic surgical procedures at younger ages. In this narrative review, studies assessing attitudes towards cosmetic surgical procedures among college-aged young adults were evaluated.

Methods

A search identified 20 studies published from 2002 to 2021 that focused on cosmetic surgical procedures among young adults. Each study used survey-based data to determine attitudes, acceptance, interests, perceptions, and beliefs about cosmetic surgical procedures among college-aged students in the United States.

Results

The proportion of college-aged participants who had undergone cosmetic surgical procedures ranged from 1.3% to 6.4% with surveys reporting that between 21 and 43% were interested in procedures in the future. In general, young women were more likely to express interest in cosmetic surgical procedures than young men. Studies consistently demonstrated an inverse relationship between body satisfaction and use of aesthetic procedures among this patient population. Other factors associated with acceptance and approval of cosmetic surgical procedures included importance of appearance to self-worth, concern with social standing and attractiveness, investment in appearance, media influence on body image, and positive attitudes towards celebrities. Exposure to cosmetic surgery advertising was correlated with increased approval of cosmetic surgical procedures, especially the perception that advertising influences "others" more than survey respondents themselves.

Conclusion

Interest in cosmetic surgical procedures continues to grow among young adults in the United States. In the future, this cohort is likely to become an increasingly important demographic to target for education, advertising, and research regarding cosmetic surgical procedures.

Attitudes towards cosmetic surgery among women in China and the Netherlands

Around the world, an increasing number of people, predominantly women, are choosing to undergo cosmetic surgery-despite the associated health risks. This study aimed to promote a better cross-cultural understanding of the correlates and predictors of favorable attitudes toward cosmetic surgery among women in China (an Eastern country where cosmetic surgery is increasing most rapidly) and the Netherlands (a Western country). Questionnaire data were obtained from 763 adult women; 245 were Chinese women in China (Mage = 29.71), 265 were Chinese women in the Netherlands (Mage = 25.81), and 253 were Dutch women (Mage = 29.22). Facial appearance concerns and materialistic belief were significant predictors of favorable attitudes towards cosmetic surgery for all three cultural groups. Body appreciation was a significant positive predictor among Chinese women in both China and the Netherlands, whereas age and beauty-ideal internalization were significant positive predictors only among Chinese women in China. The findings and their implications are discussed with respect to the characteristics of Chinese culture that could explain the identified differences between Chinese and Dutch women.

Acceptance of cosmetic surgery in adolescents: The effects of caregiver eating messages and objectified body consciousness

Cosmetic procedures are aimed at enhancing clients’ attractiveness by modifying their physical appearance. Women prefer cosmetic surgery more than men do, due to the ideal of leanness advertised by the media. Female adolescents, undergoing an emotionally unstable developmental stage, are particularly responsive to unrealistic beauty standards. The more they internalize cultural norms, the more they objectify their bodies. Young people’s views on their bodies are essentially influenced by the feedback received from their parents and other adults. The present study explored the impact of caregiver eating messages and objectified body consciousness on the acceptance of cosmetic surgery among Hungarian female students aged 14 to 19 years (M = 16.79, SD = 1.245). Self-report scales used to collect data in four secondary schools. The expected associations were tested with path analysis. Caregiver eating messages generally had an indirect positive impact on the acceptance of cosmetic surgery that was mediated by the shame component of objectified body consciousness. A direct impact was only shown by critical/restrictive caregiver messages and by the shame component of objectified body consciousness. The other two components of objectified body consciousness were unrelated to the acceptance of cosmetic surgery. In sum, caregiver messages on female adolescents’ appearance and eating habits have a formative role on their attitudes towards cosmetic surgery. Such messages predict their proneness to view their bodies as objects serving to meet certain beauty standards. The more they endorse such views, the more they are willing to consider cosmetic surgery to enhance their appearance.

Acceptance of Cosmetic Surgery among Hungarian Women in a Global Context: the Hungarian Version of the Acceptance of Cosmetic Surgery Scale (ACSS)

In recent years, the popularity of surgical cosmetic procedures has dramatically increased in the Western world. The Acceptance of Cosmetic Surgery Scale (ACSS) provides a measure of psychological acceptance of cosmetic surgery. The original instrument (ACSS) contains three subscales (Interpersonal, Social, and Consider). Since its publication, the ACSS has been adapted for many languages. The primary objective of the present study was to develop the Hungarian version of the ACSS. Furthermore, focus was laid on whether the original factor structure could be replicated with a Hungarian sample despite expectable cultural differences from other national samples. To obtain cross-culturally comparable data, the same scales were used for psychometric analysis as those used in the development of the original ACSS and its various national versions. The Hungarian sample included 482 female participants aged between 18 and 68 years (M = 29.02, SD = 10.71), who completed a questionnaire battery. Validity of the Hungarian version was tested with the following measures: the Rosenberg Self-Esteem Scale (RSES), the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3), the Satisfaction with Life Scale (SWLS), the Body Appreciation Scale (BAS), and the Photographic Figure Rating Scale (PFRS) developed for women. The results show that the obtained Hungarian version of the ACSS is a reliable and valid measure, which enables researchers in the field to study Hungarian samples. Furthermore, the factor structure of the Hungarian scale is identical with that of the original ACSS, which enables reliable cross-cultural comparisons. For these reasons, the authors expect that the Hungarian ACSS will stimulate more in-depth quantitative research on attitudes towards cosmetic surgery within the Hungarian context, and it will also contribute to a better understanding of acceptance of cosmetic surgery from a cross-cultural perspective.

The role of beauty as currency belief in acceptance of cosmetic surgery and career aspirations among Chinese young women

The current study tested the "beauty as currency" hypothesis in the framework of Objectification theory with a sample of Chinese young women. Four hundred and four college women completed a pencil-and-paper questionnaire. We hypothesized that beauty as currency would be associated with acceptance of cosmetic surgery and career aspirations through the serial meditation of self-objectification and body surveillance. The results indicated that self-objectification and body surveillance mediated the relation between women's belief in beauty as currency and acceptance of cosmetic surgery. Body surveillance mediated the relationship between beauty as currency and career aspirations. These findings provide further evidence for the "beauty as currency" hypothesis, suggesting the feminine beauty ideology may lead to women's higher acceptance of cosmetic surgery and lower career aspirations via the self-objectifying process. Our study provides some implications for understanding the effect of women's ideologies on gender system change.

Gratitude at Work Prospectively Predicts Lower Workplace Materialism: A Three-Wave Longitudinal Study in Chile

Materialism at work refers to a higher importance attached to extrinsic (e.g., money, fame, image) versus intrinsic (self-development, affiliation, community participation) employees' 'aspirations'. Research from self-determination theory has consistently found that materialism at work is strongly detrimental for both employees and organizations. For example, materialism is negatively associated with lower job satisfaction and engagement and positively associated with higher turnover intentions and job insecurity. Unfortunately, there are no viable strategies for reducing materialism in the workplace yet. In this sense, based on emergent research in psychology, we theorized that dispositional gratitude-a key construct within the Positive Organizational Psychology field-could be a protecting factor against materialism. Further, we conducted a three-wave longitudinal design among a large sample of Chilean workers (n = 1841) to test, for the first time, the longitudinal link between gratitude and materialism. We used two novel methodologies: A cross-lagged panel model (CLPM) to test between-person changes and a trait-state-occasion model (TSO) to test within-person changes. We found that both the CLPM as well as the TSO models showed that gratitude at work prospectively predicted further lower workplace materialism. Specifically, the CLPM shows that individuals with higher than average gratitude at Ti, are more likely to show lower than average materialism at Ti+1. The TSO shows that individuals with a higher than their usual level of gratitude at Ti are more likely to show a lower than their usual level of materialism at Ti+1. Important implications for materialism research as well as for the Positive Organizational Psychology field are discussed.

Transgender embodiment: a feminist, situated neuroscience perspective

The policing of boundaries of acceptable sexual identities and behaviour is a recurring theme in numerous marginalities. Gender (especially womanhood) is often instantiated socially through the harms to which members of that gender are subjected. For transgender people, the assumption that genitals define gender translates the ubiquitous misapprehension that genitals and sex are binary into an assumption that gender must also be binary. This circumscribes the potentiality of cultural intelligibility for trans gender identities, and may interfere with the ability of transgender people to select the most appropriate medical and social means of expressing their authentic identities, even altering what is possible or appropriate, thereby curtailing trans people’s authenticity and freedom. We therefore distinguish social from bodily aspects of gender dysphoria, proposing a model of their distinct, intersecting origins. We explore ways in which transgender medicine reflects aspects of other gendered surgeries, proposing a biopsychosocial understanding of embodiment, including influences of culture on the neurological representation of the body in the somatosensory cortex. This framework proposes that cultural cissexism, causes trans people to experience (neuro)physiological damage, creating or exacerbating the need for medical transition within a framework of individual autonomy. Our social-constructionist feminist neuroscientific account of gendered embodiment highlights the medical necessity of bodily autonomy for trans people seeking surgery or other biomedical interventions, and the ethical burden therein.

Factor Analysis and Psychometric Properties of the Chinese Translation of the Acceptance of Cosmetic Surgery Scale

This paper describes a Chinese translation and validation of the Acceptance of Cosmetic Surgery Scale (ACSS; Henderson-King & Henderson-King, 2005), a questionnaire for assessing attitudes towards cosmetic surgery. Chinese adults (335 women, 240 men; M_age = 33.65) completed the Chinese ACSS and - to investigate construct validity - measures of body appreciation, facial appearance concerns, sociocultural attitudes towards appearance (i.e., internalization of appearance ideals and appearance pressures), and demographics. Exploratory factor analysis revealed that the Chinese ACSS comprised two factors, which were invariant across sex, mirroring results among other non-Western samples. The Chinese ACSS also demonstrated good internal consistency (Cronbach's alphas > .90) and convergent validity via its positive associations with facial appearance concerns and overall sociocultural attitudes toward appearance. Chinese ACSS scores were higher among women, and were positively correlated with age among men. Chinese ACSS scores were not associated with body appreciation or other demographic factors. The ACSS seems to be a valid instrument for use in Chinese adults, and could bring more insight into attitudes toward cosmetic surgery from a cross-cultural perspective.

Cosmetic Surgery and Self-esteem in South Korea: A Systematic Review and Meta-analysis

PURPOSE

Advances in medical technology coupled with rapid growth of web-based mass media and social networking services have considerably increased public access to cosmetic surgery. In South Korea, in particular, the number of people undergoing cosmetic surgery has been rapidly increasing, and studies related to cosmetic surgery have markedly increased. We report an integrative review of studies examining the relationship between cosmetic surgery and self-esteem in Korea. We aimed to identify relevant variables and determine their overall effect sizes.

METHODS

This study was designed based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Two researchers separately performed the literature search, selected 16 papers based on the inclusion and exclusion criteria, and analyzed them.

RESULTS

Of the 16 papers on cosmetic surgery and self-esteem, 5 (33.3%) involved both men and women, and the remaining 11 (66.7%) involved only women. The respondents included teenagers and adults. The total number of respondents was 6296, with an average of 393.5 per paper. Most studies (n = 13, 81.3%) used the Rosenberg Self-Esteem Scale. Self-esteem was correlated with variables grouped into the following six categories: appearance management intention, cosmetic surgery intention, sociocultural attitude, body satisfaction, BMI, and stress. The effect sizes from the meta-analysis with correlation coefficients were 0.157, - 0.118, 0.023, 0.175, - 0.045, and - 0.085.

CONCLUSIONS

Among the relevant variables categorized in this study, sociocultural attitude, BMI, and stress showed weak effect sizes, and the appearance management intention, cosmetic surgery intention, and body satisfaction categories showed intermediate effect sizes. The results of this study are expected to serve as a concrete basis for the development of strategies to minimize the adverse effects of the ever-growing cosmetic surgery industry. This information can help elucidate the psychologic characteristics of individuals seeking cosmetic surgery and contribute to optimal medical outcomes.

LEVEL OF EVIDENCE IV

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.

Influence of Social Media on the Decision to Undergo a Cosmetic Procedure

Supplemental Digital Content is available in the text.

There is a rise of cosmetic procedures in Saudi Arabia. Social media have become a popular means of advertisements for cosmetic professional providers. There are currently no studies that determine the relationship between viewing cosmetic surgery advertisements and considering undergoing cosmetic procedures in female university students in Saudi Arabia.

Effects of social media use on desire for cosmetic surgery among young women

A large body of research has documented the influence of traditional media formats (e.g. television programs, adverts) on young women’s consideration of cosmetic surgery. However, less is known about how newer forms of media such as social networking sites impact desire for cosmetic surgery. The present study aimed to examine whether exposure to images depicting facial cosmetic enhancements increases the desire for cosmetic surgery among young women. One-hundred and eighteen women, aged 18–29 years, indicated their social media use. This was followed by a task in which they viewed either images of facial cosmetic enhancements (N = 59) or images of travel (N = 59). Participants then indicated their satisfaction with their appearance, their mood and desire to undergo cosmetic enhancement. The results showed that viewing images of females who have undergone cosmetic enhancements affected young women’s desire for cosmetic surgery, especially if they spent a significant amount of time on social media, followed many accounts, and were less satisfied with their appearance. These findings have implications for parents, clinicians, and policy makers for understanding how internet habits, particularly the use of social media, influence the desire for cosmetic surgery, including the psychosocial motivations underlying those intentions.

Understanding cosmetic surgery consideration in Chinese adolescent girls: Contributions of materialism and sexual objectification

Based on objectification theory and the consumer culture impact model, this study examined psychological predictors of cosmetic surgery consideration in 314 Chinese adolescent girls. Path analyses revealed several findings. First, both interpersonal sexual objectification and materialism contributed to internalized appearance ideals, which in turn related to body surveillance, body shame, and facial appearance concerns. Second, the association between materialism and internalized appearance ideals was independent of the association between materialism and interpersonal sexual objectification. Third, internalized appearance ideals were linked to cosmetic surgery consideration via body surveillance and facial appearance concerns. Fourth, while internalized appearance ideals were associated with body shame, body shame did not mediate its association with cosmetic surgery consideration. Fifth, instead of body shame, facial appearance concerns mediated that link between body surveillance and cosmetic surgery consideration as well as the link between internalized appearance ideals and cosmetic surgery consideration. This study provides support to the basic tenets of objectification theory and the consumer culture impact model as applied to Chinese adolescent girls' willingness to consider cosmetic surgery. It suggests that using a measure that is more sensitive to salient cultural concerns is important when attempting to understand body image issues in different cultural contexts.

Iranians' Perspective to Cosmetic Surgery: A Thematic Content Analysis for the Reasons

BACKGROUND

Currently, becoming beautiful is a value among Iranian society, although experts have suggested several complications of cosmetic surgery, but decision to have these surgeries has been dramatically increased in recent years. This increase has imposed high workload and costs on the health care system of the country. This study was conducted to explore the reasons why people perform cosmetic surgery in an Iranian context.

METHODS

Twenty-one subjects from both sexes who were 22-52 year-old and had undergone face plastic surgery between 1-5 years ago were enrolled and semi-structured data was collected via open interviews, while qualitative content were analyzed utilizing conventional analysis methods. Data analysis considered the theme “my face, my destiny” which contained 2 subcategories of “obtaining a chance for a better life “and” obtaining acceptance in society”.

RESULTS

The participants considered cosmetic surgery as a blessing from God that played a major role in their future, so they accepted the risks of the surgery.

CONCLUSION

Understanding experiences of these individuals may help health care team particularly nurses to consult them and other individuals who might think about doing cosmetic surgery through education to help them make a better decision for to do cosmetic surgery.

Adolescent Sexting: The Roles of Self-Objectification and Internalization of Media Ideals

We examined adolescent sexting using objectification theory as a framework. We hypothesized that sexting is a manifestation of trait self-objectification and the internalization of gender-specific media ideals about attractiveness. We conducted a cross-sectional survey of 201 Midwestern adolescents, 14–17 years old. We tested a three-stage path model, which differed for female and male adolescents. For female adolescents, self-objectification was positively associated with favorable attitudes about sexting, which further predicted two types of intentions to engage in sexting: sexting when there is trust in the sexting partner (security-based intentions) and sexting that is spurred by situational cues. Although there was a serial mediation effect of self-objectification on sexting behaviors through sexting attitudes and total sexting intentions, only the indirect effect of sexting attitudes on behaviors through security-based intentions was individually significant. For male adolescents, internalization of media ideals was positively associated with sexting attitudes, which further predicted the two types of sexting intentions. Similar to female adolescents, there was a serial mediation effect of internalization of media ideals on sexting behaviors through sexting attitudes and total sexting intentions; however, only security-based sexting intentions predicted sexting behaviors. Our results have implications regarding how to conceptualize adolescent sexting and how researchers, parents, and educators may help teenage youth to establish healthy sexting attitudes and behaviors. Additional online materials for this article are available to PWQ subscribers on PWQ’s website at http://journals.sagepub.com/doi/suppl/10.1177/0361684318809383

Materialism, Self-Objectification, and Capitalization of Sexual Attractiveness Increase Young Chinese Women's Willingness to Consider Cosmetic Surgery

Research reveals significant positive associations between materialism and cosmetic surgery consideration, yet little is known about why this relationship exists. To address this question, the present study examined potential mediators of the links between materialism and cosmetic surgery consideration. A sample of 336 Chinese undergraduate women completed measures of materialism, self-objectification, capitalization of sexual attractiveness, and cosmetic surgery consideration. Correlational analysis showed that materialism, self-objectification, and capitalization of sexual attractiveness were significantly positively correlated with cosmetic surgery consideration. The results of path analyses revealed that higher materialism predicted more willingness to consider cosmetic surgery, both directly and indirectly via higher self-objectification and capitalization of sexual attractiveness.

Adolescent Desire for Cosmetic Surgery: Associations with Bullying and Psychological Functioning

BACKGROUND

Adolescent bullying may be a key driver of interest in cosmetic surgery. This study examined the extent of such interest and whether any effect was sex-specific, and examined psychological functioning as a potential mechanism through which bullying involvement may lead to a wish for cosmetic surgery.

METHODS

A two-stage design was used. In the first stage, 2782 adolescents (aged 11 to 16 years) were screened for bullying involvement using self-reports and peer nominations. In the second stage, 752 adolescents who were bullies, victims, bully-victims, or uninvolved in bullying reported their desire for cosmetic surgery. Psychological functioning was constructed as a composite of self-esteem and emotional problems (assessed at stage 1) and body-esteem scores (assessed at stage 2).

RESULTS

Adolescents involved in bullying in any role were significantly more interested in cosmetic surgery than uninvolved adolescents. Desire for cosmetic surgery was greatest in adolescents who were bullied (victims and bully-victims) and girls. Desire for cosmetic surgery was highest in girls, but sex did not interact with bullying role. Being victimized by peers resulted in poor psychological functioning, which increased desire for cosmetic surgery. In contrast, desire for cosmetic surgery in bullies was not related to psychological functioning, which was in the normal range.

CONCLUSIONS

Bullying victimization is related to poor psychological functioning, and both are related to a greater desire for cosmetic surgery in adolescents. Cosmetic surgeons should screen candidates for psychological vulnerability and may want to include a short screening questionnaire for a history of peer victimization.

The Acceptance of Cosmetic Surgery Scale: Confirmatory Factor Analyses and Validation among Serbian Adults

We examined the validity of the Serbian version of the Acceptance of Cosmetic Surgery Scale (ACSS; Henderson-King and Henderson-King 2005). A total of 622 Serbian adults completed the ACSS, along with Serbian translations of measures for the discrepancy between actual body weight and ideal body weight, body appreciation, sociocultural attitudes toward appearance, and demographics. Confirmatory factor analyses were conducted to compare how different ACSS models fitted the collected data. A three-factor model provided the best fit to the data relative to two- and one-factor models. The three-factor model had good internal consistency, convergent and discriminant validity, and nomological validity. The ACSS seems to be a valid instrument for use in Serbian populations. Our study will contribute towards better understanding of the acceptance of cosmetic surgery from a cross-cultural perspective.

Materialistic Values and Goals

Materialism comprises a set of values and goals focused on wealth, possessions, image, and status. These aims are a fundamental aspect of the human value/goal system, standing in relative conflict with aims concerning the well-being of others, as well as one's own personal and spiritual growth. Substantial evidence shows that people who place a relatively high priority on materialistic values/goals consume more products and incur more debt, have lower-quality interpersonal relationships, act in more ecologically destructive ways, have adverse work and educational motivation, and report lower personal and physical well-being. Experimentally activating materialistic aims causes similar outcomes. Given these ills, researchers have investigated means of decreasing people's materialism. Successful interventions encourage intrinsic/self-transcendent values/goals, increase felt personal security, and/or block materialistic messages from the environment. These interventions would likely be more effective if policies were also adopted that diminished contemporary culture's focus on consumption, profit, and economic growth.

Beyond Sociocultural Influence: Self-monitoring and Self-awareness as Predictors of Women's Interest in Breast Cosmetic Surgery

BACKGROUND

The aim of the present research was to analyze the role of self-awareness, self-monitoring, perceived media pressures, and peer attributions on the consideration of breast cosmetic surgery among women. The internalization of thin ideals was taken into account as a key moderating variable.

METHODS

Participants were 132 Italian women (mean age = 33.62), who completed a questionnaire aimed at measuring the variables of interest. Path analysis was used to test our hypotheses.

RESULTS

The results indicated that perceived media pressure, self-monitoring, and peer attributions influenced participants' interest in breast modification procedures through the internalization of thin ideals. Self-awareness (both private and public) had a direct effect on women's consideration of breast cosmetic surgery.

CONCLUSIONS

This research is one of few analyzing how specific aspects of the self could influence women's interest in cosmetic surgery. These findings contribute to the understanding of the reasons that trigger women's interest in cosmetic surgery. Not only sociocultural influences contribute to the development of favorable attitudes toward cosmetic surgery, but also specific aspects of the self have a relevant role.

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 factor structure and psychometric properties of the Italian version of the Acceptance of Cosmetic Surgery Scale

The current study examined the validity of the Italian version of the Acceptance of Cosmetic Surgery Scale (ACSS; Henderson-King & Henderson-King, 2005) in a sample of 378 Italian adult women. A series of confirmatory factor analyses were conducted. A three-factor solution provided the best fit to the data and confirmed the Intrapersonal, Social, and Consider dimensions. The three factors were strongly inter-correlated. Cronbach's alphas were high (all alphas>.86). The scale showed good convergent and discriminant validity (estimated by Composite Reliability and the Average Variance Extracted). The nomological validity of the Italian version of the ACSS was confirmed by its significant correlations with participants' body dissatisfaction and sociocultural influences (internalization of thin ideals and perceived media pressure). The ACSS seems to be a useful measure of acceptance of cosmetic surgery in the Italian context. This instrument can be used with Italian speakers for research, health promotion, and preventive interventions.

Psychosocial predictors in consideration of cosmetic surgery among women

BACKGROUND

This study aimed to analyze the influence of psychosocial factors on the consideration of cosmetic surgery. The authors hypothesized that the internalization of thin ideals and social comparisons mediate the relationship between media pressure, family and peer influence (appearance conversations, perception of teasing, and peer attributions), and the desire to pursue cosmetic surgery.

METHODS

The study participants were 429 Italian women (mean age, 33 years). They completed a questionnaire containing the Appearance Conversations With Friends Scale, the Perception of Teasing Scale for Friends, the Peer Attribution Scale, the "Pressure and Internalization-General" subscales of the Sociocultural Attitudes Towards Appearance Questionnaire-3, the Feedback on Physical Appearance Scale, the Physical Appearance Comparison Scale, and the "Consider" subscale of the Acceptance of Cosmetic Surgery Scale. Hierarchical linear regression was performed.

RESULTS

The results indicated that media pressure and appearance conversations with peers predicted the outcome variable through the full mediation of internalization of thin ideals. The relation between peer attributions and interest in cosmetic surgery was partially mediated by internalization of thin ideals. Although social comparison was significantly related to both sociocultural variables and consideration of cosmetic procedures, it was not a significant mediator of this relationship. Neither family influence nor perception of teasing predicted the outcome variable.

CONCLUSIONS

Overall, these results provide important information about the factors implicated in the consideration of cosmetic surgery by women. This research confirms that cosmetic surgeons need to adopt a base psychological approach.

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 .

Adolescent girls’ views on cosmetic surgery: A focus group study

This study examined adolescent girls’ views of cosmetic surgery. Seven focus groups were run with girls aged 15–18 years ( N = 27). Participants read case studies of women having cosmetic surgery, followed by discussion and exploration of their views. Thematic analysis identified four themes: (1) dissatisfaction with appearance, (2) acceptability of cosmetic surgery, (3) feelings about undergoing cosmetic surgery and (4) cosmetic surgery in the media. Results suggest the acceptability of cosmetic surgery varies according to the reasons for having it and that the media play an important role by normalising surgery and under-representing the risks associated with it.

The influence of materialism and ideal body internalization on body-dissatisfaction and body-shaping behaviors of young men and women: support for the Consumer Culture Impact Model

Exposure to media images of the 'body-perfect' ideal has been partly blamed for the pursuit of thinness among women and muscularity among men. Research has largely overlooked the materialistic messages frequently associated with these images. We present findings from two studies with Icelandic students aged 18-21, one focusing on young women (n = 303) and one on young men (n = 226), which test associations of materialistic and body-perfect ideals with body dissatisfaction and excessive body shaping behaviors. In both studies, the internalization of materialistic values is strongly linked to the internalization of body-perfect ideals: the thin-ideal for young women, and the muscular-ideal for young men. A materialist value orientation also predicted body dissatisfaction in both studies, and was linked to body shaping behaviors, albeit differently for young women and men. Thus, the research identifies materialism as a further correlate of both body dissatisfaction and excessive body-shaping behaviors. The findings support Dittmar's (2008) Consumer Culture Impact Model, which proposes that the body-perfect and 'material good life' ideals jointly impact well-being.

Cutting Words

We examined whether subtle exposure to sexually objectifying cues increases women’s intentions to have cosmetic surgery. Undergraduate women ( N = 116) were randomly assigned to a condition in which they unscrambled sentences containing words associated with sexual objectification, non-self-objectifying physicality, or neutral content. Following a manipulation check of these primes, participants reported their body shame and intentions to have cosmetic surgery in the future. Results revealed that priming a state of self-objectification, compared to the two non-self-objectifying conditions, increased both body shame and intentions to have cosmetic surgery. In a mediational model, the link between self-objectification and intentions to have cosmetic surgery was partially mediated by body shame. Controlling for other key intrapersonal and social motives linked to interest in cosmetic surgery did not alter these patterns. These findings highlight the potential for the consumption of cosmetic surgery to stand as another harmful micro-level consequence of self-objectification that may be perpetuated via subtle exposure to sexually objectifying words, even in the absence of visual depictions or more explicit encounters of sexual objectification.

To Cut or Not to Cut: Cosmetic Surgery Usage and Women's Age-Related Experiences

Part of the developmental trajectory of middle and late life presumes the adjustment to physical aging, an adjustment that is complicated for women for whom the prioritization of beauty is central to their social value in Western societies. A 60-item written questionnaire was distributed to a volunteer community sample of 202 women ages 19–86. From these data, this study tested whether women's cosmetic surgery usage would act as a protective factor in age-related experiences related to body image, self-esteem, and aging attitudes. Cosmetic surgery recipients evidenced less body satisfaction, and more appearance investment with age increases while only non-recipients showed improvements in self-esteem ratings with advancing age. Both recipients and non-recipients showed declines in body care with age, a greater felt discrepancy between actual and perceived age, and less aging anxiety—but non-recipients more so than recipients. Thus, despite having undertaken action to improve their appearance through surgical means at some point in their adult lives, cosmetic surgery recipients did not inevitably feel younger than their years, or better about themselves, compared to those who have not pursued surgery. Study limitations and implications are outlined, and given that cosmetic surgery may become normative practice in future cohorts of aging adults, it concludes with a call for nationally-representative studies using matched-control group research designs typical of public health inquiry more generally.

Factor structure and correlates of the acceptance of cosmetic surgery scale among South Korean university students

BACKGROUND

Research on the acceptance of cosmetic surgery has focused on relatively affluent Western samples, to the exclusion of non-Western samples and any potential cross-cultural differences. While rates of cosmetic surgery in South Korea have risen sharply in the past decade, mirroring rates in other East Asian nations, little is known about attitudes toward cosmetic surgery in the Korean population.

OBJECTIVES

To examine the factor structure and correlates of a Korean adaptation of the previously-published Acceptance of Cosmetic Surgery Scale (ACSS).

METHODS

South Korean university students (N = 267) completed the ACSS, as well as included Korean translations of measures for actual vs. ideal body weight discrepancy, body appreciation, sociocultural attitudes toward appearance, and demographics.

RESULTS

The Korean ACSS reduced to a two-factor solution, mirroring results among other non-Western samples, although a one-factor solution was deemed more plausible. Compared to men, women had significantly higher total scores, suggesting that they were more accepting of cosmetic surgery. A multiple regression showed that, after controlling for the effects of participant sex, the only significant predictor of acceptance of cosmetic surgery was general body appreciation, suggesting that some may view cosmetic surgery as a means of enhancing their body image.

CONCLUSIONS

The results reveal important global information for plastic surgeons-not only on the treatment of non-Western patients but on the South Korean market, in which the cosmetic surgery industry remains unregulated. Given the popularity and acceptance of cosmetic surgery in South Korea, there is an urgent need for regulatory intervention to ensure patient safety and satisfaction.

Acceptance of Cosmetic Surgery Among British Female University Students

Although patients of cosmetic surgery are increasingly ethnically diverse, previous studies have not examined ethnic differences in attitudinal dispositions toward cosmetic surgery. In the present study, 751 British female university students from three ethnic groups (Caucasians, South Asians, and African Caribbeans) completed measures of acceptance of cosmetic surgery, body appreciation, self-esteem, and demographic variables. Initial between-group analyses showed that Caucasians had lower body appreciation and self-esteem than Asian and African Caribbean participants. Importantly, Caucasians had higher acceptance of cosmetic surgery than their ethnic minority counterparts, even after controlling for body appreciation, self-esteem, age, and body mass index. Further analyses showed that ethnicity accounted for a small proportion of the variance in acceptance of cosmetic surgery, with body appreciation and self-esteem emerging as stronger predictors. Possible reasons for ethnic differences in acceptance of cosmetic surgery are discussed in Conclusion.

Celebrity worship and incidence of elective cosmetic surgery: evidence of a link among young adults

PURPOSE

The purpose of the current study was to explore among young adults whether celebrity worship predicted the incidence of elective cosmetic surgery within the period of 8 months after controlling for several known predictors of elective cosmetic surgery.

METHODS

A total of 137 young adults completed questionnaire measures of attitudes toward a celebrity whose body image they admired, previous and vicarious experience of elective cosmetic surgery, attitudes toward cosmetic surgery, and a range of psychological and demographic measures at time 1. Participants were then asked to report whether they had undergone elective cosmetic surgery 8 months later.

RESULTS

After controlling for several known predictors of elective cosmetic surgery, intense-personal celebrity worship of a celebrity whose body shape was admired by the participant predicted the incidence of elective cosmetic surgery within an 8-month period.

CONCLUSIONS

The current findings suggest that the type of para-social relationship that young adults form with celebrities, particularly with those whose body shape is admired, may need to be considered by those when speaking to, and educating, young people about their choices around elective cosmetic surgery.

Factors Influencing Need for Cosmetic Surgery among High School Girls

PURPOSE

The increase of cosmetic surgery procedures is partly motivated by more positive attitude toward cosmetic surgery as a means of improving physical appearance. In this study factors expected to predict need for cosmetic surgery were examined.

METHODS

A descriptive design was used with 321 high school girls who completed a questionnaire about sociocultural attitudes toward appearance, body image, self-esteem, and need for cosmetic surgery. Stepwise multiple regression analysis was performed to examine factors affecting need for cosmetic surgery.

RESULTS

Bivariate correlations showed that need for cosmetic surgery was positively correlated with internalization and awareness of sociocultural attitudes toward appearance, and appearance orientation in body image and negatively correlated with self-esteem and ideal body mass index (BMI). Multiple regression showed that the predictive variables explained 22.1% in need for cosmetic surgery. The significant factors influencing need for cosmetic surgery were greater internalization and awareness of sociocultural attitudes toward appearance, better appearance evaluation and higher appearance orientation in body image, lower self-esteem, and lower ideal BMI.

CONCLUSION

Overall, results of this research suggest that prevention of media influence and body image disturbances, and promotion of self-esteem are very important to young women.

Translation and validation of the Malay Acceptance of Cosmetic Surgery Scale

The present study examined the psychometric properties of a Malay translation of the Acceptance of Cosmetic Surgery Scale (ACSS; Henderson-King & Henderson-King, 2005). A total of 373 Malaysian women completed the ACSS along with measures of ideal-actual weight discrepancy, body appreciation, sociocultural attitudes toward appearance, self-esteem, life satisfaction, and demographics. Results showed that the Malay ACSS was best reduced to a two-factor solution, although an overall score of all 15 ACSS items showed the highest internal consistency. Results also showed that this overall score had good discriminant and divergent validity. It is expected that the availability of a Malay version of the ACSS will stimulate cross-cultural research on the acceptance of cosmetic surgery.