Changing to Impress: Testing a Mediation Model from Instagram Self-presentation to Cosmetic Surgery

BACKGROUND

This study examined the relationship between false self-presentation on Instagram and consideration of cosmetic surgery through the mediating role of body image control in photos (BICP), photo manipulation, and body shame. We predicted that false self-presentation on Instagram was indirectly associated with cosmetic surgery intentions through the aforementioned constructs.

METHODS

A total of 504 young Italian adults (28.2% males, 18-30 years) completed an online survey. They completed a questionnaire containing the Self-presentation on Instagram Questionnaire, the Body Image Control in Photos Questionnaire-revised, the Photo Manipulation Scale, the Objectified Body Consciousness Scale, and the Acceptance of Cosmetic Surgery Scale. The pattern of associations between the constructs was analyzed via path analysis.

RESULTS

The results show that false self-presentation on Instagram was associated with photo manipulation, both directly and indirectly, through BICP. Furthermore, photo manipulation was linked to body shame, but neither of them was associated with cosmetic surgery intentions. Finally, false self-presentation on Instagram was associated with the consideration of cosmetic surgery only through the mediation of BICP.

CONCLUSION

Findings indicate that self-presentation styles might affect Instagram photo behaviors and individuals' cosmetic surgery intentions, suggesting that surgeons should fully examine patients' motivations before providing them with services. Furthermore, intervention programs encouraging users to present a more authentic version of themselves online might reduce the risk of self-objectification and reduce the consideration of procedures aimed at modifying one's body for purely aesthetic reasons.

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 .

Self-objectification and cosmetic surgery consideration among Chinese young women: The mediating roles of alienation and body image inflexibility

The behavior of undergoing cosmetic surgery is a coping strategy for body-image threats and challenges. Self-objectification is associated with alienation and body image inflexibility, and all of these are associated with stronger cosmetic surgery considerations. This study evaluated the relationship between self-objectification and cosmetic surgery consideration, and whether this relationship was mediated by alienation and body image inflexibility. The participants were 650 Chinese female college students. Serial mediation analysis indicated that the relationship between self-objectification and cosmetic surgery consideration was significantly mediated by alienation followed by body image inflexibility. The total mediating effect value was 0.424, accounting for 57.5% of the total effects. These results suggest that reducing alienation and improving the flexibility of body image can reduce the influence of self-objectification on young women's willingness to undergo cosmetic surgery. These findings provide a basis for intervening or preventing the self-objectified young women's willingness for cosmetic surgery.

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.

Mediating effects of self-concept clarity and self-objectification on the relationship between celebrity worship and the process of considering cosmetic surgery among Chinese undergraduates

Background

Several studies have examined the relationship between celebrity worship and cosmetic surgery; however, few have discussed the mediating role of self-concept. To fill this research gap, the present study aims to examine the mediating roles of self-concept clarity and self-objectification in the association between celebrity worship and cosmetic surgery.

Methods

A sample of 1,089 Chinese undergraduates (Mage = 20.32; SDage = 2.60) completed measures of celebrity worship, actively considering cosmetic surgery, self-concept clarity, and self-objectification. Mediating effect analysis was used to test the hypothesis.

Results

The results showed that celebrity worship, cosmetic surgery consideration, and self-objectification were positively correlated, whereas self-concept clarity was negatively correlated with all three variables. Mediation analysis revealed that celebrity worship predicted consideration of cosmetic surgery not only directly but also through three indirect paths through the mediating role of (1) self-concept clarity, (2) self-objectification, and (3) the chain mediating role of self-concept clarity and self-objectification.

Conclusions

These findings broaden our understanding of the psychological processes that underlie the association between celebrity worship and considering cosmetic surgery and afford practical guidance on reducing the risks associated with cosmetic surgery.

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.

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

There is an established relationship between acceptance of cosmetic surgery and psychological factors, including body image. However, qualitative research among diverse cultural groups is needed to provide a more fine-grained understanding of the influences on women's attitudes towards cosmetic surgery. In this study, 20 Chinese and 20 Dutch women aged 18-50 years (M_Chinese = 34.20; M_Dutch = 34.70) participated in one-on-one semi-structured interviews. Data were analyzed using reflexive thematic analysis. We identified three themes that captured the factors that women perceived to foster favorable attitudes towards cosmetic surgery: (a) sociocultural pressures (e.g., normalization of cosmetic surgery, appearance-focused peers); (b) intrapersonal characteristics (e.g., beauty-ideal internalization, social comparison); and (c) benefits of beauty (e.g., attracting men, socioeconomic benefits). Conversely, two themes captured the factors perceived to reduce favorable attitudes towards cosmetic surgery: (a) intrapersonal characteristics (e.g., unconditional body acceptance, self-confidence); and (b) external considerations (e.g., health risks, financial costs). Overall, Chinese and Dutch participants shared many similarities in their opinions about what might affect cosmetic surgery consideration. The most striking cross-cultural differences concerned perceived socioeconomic benefits of beauty (mainly Chinese women) and women's conceptualization of body appreciation. This study may enable a more comprehensive understanding about the factors influencing Chinese and Dutch women's attitudes towards cosmetic surgery, and the nuances in these relationships across these cultures.

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.

Instagram Sexualization: When posts make you feel dissatisfied and wanting to change your body

Instagram is a visually centered social media that involves the presence of sexualized imagery posted by users. Such Instagram sexualization may have a negative impact on women's body image. The present study examined whether exposure to Instagram sexualization, namely posts of sexualized women along with appearance-related comments, affected women's body satisfaction and cosmetic surgery intentions. In doing so, it also considered the moderating role of Instagram Addiction Proclivity (IAP). Young Italian female participants (N = 247) were randomly exposed to one of four video conditions resulting from the combination of either sexualized or non-sexualized women's pictures on Instagram, paired with appearance or neutral comments. In the sexualized picture condition participants' body dissatisfaction increased compared to pre-exposure levels and to the non-sexualized picture condition. The type of comments did not affect participants' body satisfaction. Moreover, IAP predicted cosmetic surgery intentions and moderated their reactions to Instagram content. Indeed, the higher the IAP, the higher the cosmetic surgery intentions of participants viewing sexualized pictures with neutral comments and non-sexualized pictures with body appearance comments. These findings suggest that female Instagram users should be aware of the negative impacts of viewing sexualized imagery as well as the role that IAP may play.

The cosmetic surgery paradox: Toward a contemporary understanding of cosmetic surgery popularisation and attitudes

Modern women feel compelled to meet near-impossible standards of beauty. For many, this pursuit ultimately culminates in cosmetic surgery - a radical form of beautification that is rapidly becoming popular worldwide. Paradoxically, while prevalent, artificial beauty remains widely unaccepted in contemporary society. This narrative review synthesizes feminist dialogue, recent research, and real-world case studies to argue that female beauty standards account for both the growing popularity of cosmetic surgery and its lack of mainstream acceptance. First, we implicate unrealistic beauty standards and the medicalization of appearance in popularizing cosmetic surgery. Second, we analyze how negative attitudes toward cosmetic surgery are also motivated by unrealistic beauty standards. Finally, we generate a synthesized model of the processes outlined in this review and provide testable predictions for future studies based on this model. Our review is the first to integrate theoretical and empirical evidence into a cohesive narrative that explains the cosmetic surgery paradox; that is, how cosmetic surgery remains secretive, stigmatized, and moralized despite its surging popularity.

When looking 'hot' means not feeling cold: Evidence that self-objectification inhibits feelings of being cold

Self-objectification, the internalization of an observer's appearance-based perspective of one's body, has been theorized and demonstrated to reduce body awareness among women. In this field study, we propose self-objectification as the mechanism to explain the oft-observed phenomenon where women wearing little clothing appear unbothered by cold weather, positing that self-objectification obstructs women's feelings of cold. We surveyed women outside nightclubs on cold nights, assessed self-objectification, and asked participants to report how cold they felt. Anonymous photos were taken and coded for amount of skin exposure. We hypothesized that self-objectification would moderate the relationship between clothing coverage and reports of feeling cold. Our hypothesis was supported: women low in self-objectification showed a positive, intuitive, relationship between skin exposure and perceptions of coldness, but women more highly focused on their appearance did not feel colder when wearing less clothing. These findings offer support for the relationship between self-objectification and awareness of bodily sensations in the context of a naturalistic setting. We discuss implications of these findings, and also consider limitations, an alternative explanation, and directions for future research.

Body Talk on Social Networking Sites and Cosmetic Surgery Consideration Among Chinese Young Adults: A Serial Mediation Model Based on Objectification Theory

People’s interest in cosmetic surgery has increased in recent years. Drawing from objectification theory, in the present study, we examined the associations of body talk on social networking sites (SNS), body surveillance, and body shame with cosmetic surgery consideration. In particular, we examined the mediating roles of body surveillance and body shame in the relationship between SNS body talk and cosmetic surgery consideration. We also examined potential gender differences in the serial mediation model. Male and female college students in China ( N = 309) completed questionnaires regarding SNS body talk, body surveillance, body shame, and cosmetic surgery consideration. Results showed that SNS body talk, body surveillance, and body shame were positively associated with cosmetic surgery consideration. Body surveillance and body shame mediated the association between SNS body talk and cosmetic surgery consideration both separately and sequentially. Gender did not moderate any of the relations in the serial mediation model. Findings of this study provide new insight into the relationship between SNS use and cosmetic surgery and highlight facets of objectification as potential targets for prevention and intervention regarding appearance concerns.

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.

Why do selfies increase young women's willingness to consider cosmetic surgery in China? The mediating roles of body surveillance and body shame

The present study was designed to examine a possible two mediator model with both body surveillance and body shame mediating the association of selfie behavior with cosmetic surgery consideration in young adult women. A sample of 588 young adult women participated in this study and completed questionnaires regarding selfie behavior, body surveillance, body shame, and cosmetic surgery consideration. Results indicated that selfie behavior was positively related to cosmetic surgery consideration. In addition, the mediation analysis by PROCESS revealed that body surveillance and body shame mediated the relation between selfie behavior and cosmetic surgery consideration. These findings add to the extant literature by suggesting that selfie behavior may be a new experience of self-objectification, which provide new insights into the relation between selfie activities and cosmetic surgery consideration in young women.

Women’s Intrasexual Competition Results in Beautification

Psychology research focuses primarily on male competition. This research, however, investigates women’s competition for love and the ideal partner in the mating market and reveals one psychological consequence for women, that is, beautification. This is demonstrated with ecologically valid, real-world archive and online search query data, a quasi-experiment, and a series of controlled experiments with random assignments. Intrasexual competition, indexed by the operational sex ratio (OSR) and income inequality (GINI), predicts women’s beautification reflected by Google search queries for cosmetic surgery terms (Study 1) and the density of certificated plastic surgeons (Study 2). Female college students from faculties with female-biased OSRs exhibit greater appearance focus than women from male-biased faculties (Study 3). A causal relationship, between women’s intrasexual competition and beautification (and even self-objectification), is subsequently demonstrated in experiments (Studies 4–6). Additionally, self-objectification due to intrasexual competition leads to women’s preference for appearance-oriented products (Study 6). Implications are discussed.

Providing Sexual Companionship for Resources: Development, Validation, and Personality Correlates of the Acceptance of Sugar Relationships in Young Women and Men Scale (ASR-YWMS)

A sugar relationship is a transactional sexual relationship in which a younger partner (sugar baby/boy) offers companionship and sexual services to a much older partner (sugar daddy/mommy) in return for material compensation. One aim of the present study was to develop an attitude scale assessing young women's and men's acceptance of sugar relationships. Another aim was to explore the possible associations of the acceptance of sugar relationships with psychological functioning in an intimate partner relationship and in a sexual relationship and with certain socially undesirable personality traits. Two online studies were conducted with a total number of 2052 participants (1879 women; age = 18-28 years). The results show that the Acceptance of Sugar Relationships in Young Women and Men Scale (ASR-YWMS) is a reliable and valid measure of young people's attitude toward sugar relationships. The studies revealed that young women's and men's accepting attitude toward sugar relationships was positively associated with unrestricted sociosexuality, a game-playing love style (Ludus), self-focused sexual motivation (Study 1; N = 319; 272 women and 47 men), and with socially undesirable traits such as Machiavellianism, subclinical psychopathy, and a borderline personality organization (Study 2; N = 1733; 1607 women and 126 men). These findings suggest that a relatively high level of acceptance of sugar relationships is part of a mating strategy focused on opportunities of maximizing resources. This utilitarian, risk-taking and exploitative attitude is characteristic to a fast life history strategy, and it is a fundamental organizing principle of psychological and sexual functioning in intimate partner relationships.

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.

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.

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.

Experimental Studies on State Self-Objectification: A Review and an Integrative Process Model

This paper provides an organizing framework for the experimental research on the effects of state self-objectification on women. We explain why this body of work, which had grown rapidly in the last 20 years, departs from the original formulation of objectification theory (Fredrickson and Roberts, 1997). We compare the different operationalizations of state self-objectification and examine how they map onto its theoretical definition, concluding that the operationalizations have focused mostly on one component of this construct (concerns about one's physical appearance) while neglecting others (adopting a third-person perspective and treating oneself as a dehumanized object). We review the main findings of studies that experimentally induced state self-objectification and examined its affective, motivational, behavioral, cognitive, and physiological outcomes. We note that three core outcomes of this state as specified by objectification theory (safety anxiety, reduced flow experiences, and awareness of internal body states) have hardly been examined so far. Most importantly, we introduce an integrative process model, suggesting that the reported effects are triggered by four different mechanisms: appearance monitoring, experience of discrepancy from appearance standards, stereotype threat, and activation of the "sex object" schema. We propose strategies for distinguishing between these mechanisms and explain the theoretical and practical importance of doing so.

Trappings of femininity: A test of the "beauty as currency" hypothesis in shaping college women's gender activism

This study investigated whether believing beauty is a primary currency for women operates as an antecedent force in the relation between self-objectification and gender activism. Ninety-four ethnically diverse women attending a small liberal arts college in the southeastern United States completed the study questionnaires online for course credit. Preliminary results demonstrated beauty as currency belief, self-objectification, and support for the gender status quo were negatively associated with gender activism. A serial mediation analysis revealed support for the proposed model: Beauty as currency belief was indirectly and inversely linked to gender activism through self-objectification and support for the gender status quo, offering initial evidence for our beauty as currency hypothesis. These findings suggest belief in the notion women will reap more benefits from their bodies than other attributes or pursuits may be an important legitimizing feature of feminine beauty ideology that works through self-objectification against gender social change.

Predictors of Consideration of Labiaplasty

Our study investigated predictors of consideration of labiaplasty (the surgical reduction of the labia) using a sociocultural framework. A sample of 351 heterosexual adult Australian women aged 18–69 years completed measures of media exposure, peer influence, relationship quality, internalisation of the genital ideal, genital appearance comparison, genital appearance dissatisfaction, and consideration of labiaplasty. Almost all predictor variables were significantly correlated with consideration of labiaplasty. A structural equation model based on the Tripartite Influence Model focused on beauty ideals showed a good level of fit to the data: The effects of media exposure and peer influence on genital appearance dissatisfaction and consideration of labiaplasty were mediated by internalisation of the genital ideal and genital appearance comparison. We concluded that media exposure, peer influence, and relationship quality influenced consideration of labiaplasty both directly and indirectly. The results contribute to a greater understanding of the sociocultural motivations behind labiaplasty and also demonstrate an important extension of the Tripartite Influence Model beyond the explanation of disordered eating behaviours to the consideration of a specific form of cosmetic surgery. The development of media literacy programmes may be beneficial in addressing genital appearance concerns in young girls.