Predictive factors for cosmetic surgery: a hospital-based investigation

The association between use of social media and the development of body dysmorphic disorder and attitudes toward cosmetic surgeries: a national survey

Introduction

Body dysmorphic disorder (BDD) causes distress due to one's negative appraisal of their body image. The development of BDD has been linked to the passive use of social media and photo-editing apps. People with BDD typically pursue cosmetic surgeries to remedy their perceived flaws. The dramatic increase in the use of photo-editing apps and their well-established effects on mental health is a public health concern.

Purpose

To study the association between use of social media and the development of BDD and acceptance toward cosmetic surgeries (ACSS) among Saudis.

Methods

An online, cross-sectional, validated survey conducted among Saudis 18 and older. Descriptive analyses were utilized for demographics and prevalence rates of main study variables. ANOVA was used to compare mean scores in BDD and ACSS among different demographic groups. Tukeys post-hoc test was done to identify the categories that were different when the ANOVA test showed a statistically significance. A p-value of <0.05 was considered statistically significant.

Results

A total of 1,483 Saudi adults completed the questionnaire. Key results showed that BDD was found in 24.4 % of the sample. The percentage of participants with BDD who spent 4-7 h per day on Instagram and Snapchat (29%) was significantly higher than those who spent only less than an hour per day on these platforms (19%) (p < 0.001). Individuals with BDD had a significantly higher risk of accepting cosmetic surgery compared to those without BDD (p < 0.001).

Conclusion

A growing body of evidence suggests that social media may impact mental health in different ways. This study reveals that heavy use of these platforms is associated with negative appraisals about one's physical appearance, and it fosters one's tendency toward cosmetic surgery, especially among females.

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

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.

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.

Impact of Self-Esteem and Self-Perceived Body Image on the Acceptance of Cosmetic Surgery

Backboard Cosmetic surgery is the preservation, rebuilding, or improvement of the physical appearance of an individual through surgical and non-surgical methods. In the last few years, an increase in the number of cosmetic procedures was noticed worldwide. This increase suggests due to multifactorial changes in people's attitudes towards cosmetic surgery and concern about their physical appearance. This study aims to assess the impact of self-esteem and self-perceived body image on the acceptance of cosmetic surgery and other related factors in the Eastern province of Saudi Arabia. Material and methods This was a cross-sectional study carried out in the Eastern region of Saudi Arabia. The study was conducted between May and August 2021. A self-administrated questionnaire was distributed to all the participants who are attending plastic surgery clinics and online through social media. Three valid and reliable scales were used [Acceptance of Cosmetic Surgery Scale (ACSS), Body Appreciation Scale (BAS), Rosenberg Self-Esteem Scale (RSE)] to assess the relationship between these variables and other factors. The data were analyzed by using two-tailed tests. P-value less than 0.05 was statistically significant. Correlation analysis was done by using the Pearson correlation coefficient (r). Results A total of 1008 participants were included in the study with a response rate of 67%. Participant's ages ranged from 18 to 54 years with a mean age of 34.7 ± 11.2 years old. The study participants showed an average level of acceptance with a mean score % of 55.4% comparing to body appreciation; it was 74.2% higher with a more than average level of self-esteem, 24.7 out of 40 points for self-esteem with a mean score of 61.8%. Participants with a history of cosmetic surgery had significantly higher acceptance score than who did not (mean score of 72.6 compared to 57.1; P=0.001). Male participants had better body appreciation than females (mean score of 50.2 vs. 47.6, respectively; P=0.013). A weak positive correlation with no significance was found between participants' self-esteem and their acceptance of cosmetic surgery. Conclusion A better understanding of the acceptance of cosmetic surgery from a different cultural perspective and other related factors including social, psychological, and self-esteem are crucial for the plastic surgeon to ensure patient satisfaction.

Relationship between Socioeconomic Factors and Incidence of Cosmetic Surgery in Tehran, Iran

Background

Cosmetic surgery accompanied with high economic cost is increasing in Iran. It is necessary to be aware about factors affecting cosmetic surgery in order to control its increasing trend. Therefore, we aimed to determine the factors affecting the incidence of cosmetic surgery in Tehran, Iran.

Methods

This survey was conducted on 2002 subjects between the ages of 15 to 60 yr using random digit dialing in Tehran, Iran 2015. Demographic data was collected from all of participants and in the presence of cosmetic surgery, the related cosmetic questions were asked in details. Cosmetic surgery was considered as an event and the incidence rate ratio for variables were estimated. For univariate analysis, Poisson regression was used as well as multi-level Poisson regression was used for multivariate analysis.

Results

Totally, 224 participants (11%) undergone cosmetic surgery. There was a significant relationship between the age at surgery of participants with the incidence of cosmetic surgery (P<0.001). Cosmetic surgery in women was 1.9 times greater than in men (P <0.001). Incidence Rate Ratio (IRR) for the average and wealthy economic status in comparison to poor level was estimated (IRR=5.6, CI%95: 3.64,8.63) and (IRR=3.14, CI%95: 1.93,5.11), respectively. In addition, according to multivariate analysis all variables except the level of education and occupation, had significant relationship with the incidence of cosmetic surgery (P<0.001).

Conclusion

Cosmetic surgery was related to socioeconomic and demographic factors. Given the high economic burden of this unnecessary surgery, it can be effective to emphasize on awareness-raising programs for those are more likely to undergo cosmetic surgery.

Factors Affecting the Desire to Undergo Cosmetic Procedures Among the Nurses of Kermanshah, Iran: A Cross-Sectional Study

The number of people undergoing cosmetic procedures (CP) has been growing around the world in recent years. The aim of this study was to determine factors involved in the desire of nurses to undergo CP. A total of 360 nurses were recruited in this cross-sectional study. Stratified random sampling was used to select the samples. The data were collected using the Social Appearance Anxiety Scale and a questionnaire addressing social factors affecting the desire to undergo CP. More than half of the nurses (56.7%) were willing. Gender, social factors, and social appearance anxiety (SAA) were associated with undergoing CP. The results of logistic regression indicated that women were four times more willing to undergo CP than men, and for each unit increase in SAA score, the odds of desiring to undergo CP increased by 1.04. The Hosmer-Lemeshow test confirmed the goodness-of-fit of the regression model. Moreover, 3 independent variables of gender, SAA, and social factors were powerful predictors of the desire to undergo CP that could explain 39.9%-53.6% of changes in the desire to undergo CP. Further studies are needed to investigate the amount of CP and motivations to undergo CP in nurses.

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.

Trends and demographic characteristics of Saudi cosmetic surgery patients

OBJECTIVES

To  present the demographic characteristics of Saudi patients undergoing cosmetic procedures.  Methods: This prospective study survey was conducted in 3 private cosmetic surgery centers in different regions of Saudi Arabia (Riyadh and Jeddah) between January and August 2016. Validated questionnaire with modification was used and the following patient's information were provided: age group, height and weight, marital status, number of children, age of the patient's spouse, educational level, monthly income, name of the cosmetic procedure, names of any previous cosmetic procedures and their reason for cosmetic procedure. Results: The present study revealed that a typical Saudi cosmetic surgery patients are university graduates, married (46.8%), employed (68.3%), and middle aged 20-40 years of age (70%), with a fairly high typical monthly income.  Conclusion: There is a possible positive correlation between gender and undergoing cosmetic procedure. Laser hair removal, botox, liposuction, filler, and scar revision are common among females, while rhinoplasty is a common procedure among males.