Attitudes towards cosmetic surgery among women in China and the Netherlands

Aesthetic Procedures and Psychological Wellbeing in Saudi College Students: An In-Depth Exploration

Purpose

Minimally invasive aesthetic procedures are widely popular among the youth. Despite their prevalence, there is a significant gap in the research concerning the relationship between these procedures and psychological wellbeing, as well as an insufficient exploration of the barriers and motivators influencing their adoption, this study aims to address these gaps.

Methods

This cross-sectional study has utilized a secure online survey directed at Saudi university students as the target population. The survey was consisting of 18-item electronic questionnaire including of 4 parts (demographical data, history of psychological illness and screening of current psychological wellbeing using WHO-5 well-being tool, history of doing cosmetic procedure, or willingness to do in the future, barriers and motivators to do cosmetic procedures), and it was distributed across multiple social media platforms.

Results

A total of 8443 college students completed the study questionnaire. Exactly 1096 (13%) of the students underwent a cosmetic procedure. The most reported procedures were laser hair removal (9.1%), filler (5.3%), skin boosters (2.8%), and Botulinum toxin A injections (Botox) (2.6%). The most ranked motivators were being painless, with no side effects (8.8 out of 10), followed by being free (8.0 out of 10) and enhancing self-confidence (7.4 out of 10).

Conclusion

No significant difference recorded at the overall psychological well-being score between who underwent cosmetic procedures and who did not.

Validation of the translated Negative Physical Self Scale in a sample of Asian women living in Canada

OBJECTIVES

Body dissatisfaction is often linked to the internalization of Western beauty standards. Existing measures of body dissatisfaction, developed in Western societies, may fail to capture complex variations across ethnicities and cultures. The Negative Physical Self Scale (NPSS) assesses cognitive, affective, perceptual, and behavioural facets of body dissatisfaction. While unique in its consideration of Chinese ideals of body image, the NPSS has recently been translated and validated in a North American sample. The English-translated version of the NPSS has the potential to be an appropriate body dissatisfaction assessment tool for Asian women living in North America. The current study aims to validate the NPSS in an Asian female population living in Canada.

METHODS

A sample of 899 undergraduate women residing in Canada with self-identified Asian ethnicity completed an online survey consisting of the NPSS and other measures of body dissatisfaction.

RESULTS

An initial confirmatory factor analysis indicated that the four-factor structure of the NPSS, previously suggested in a primarily non-Asian North American sample, was a poor fit for the data. A second-order multidimensional model, based on a model proposed during the original development of the NPSS in a Chinese sample, indicated good fit once items were removed due to loadings < .60. High internal consistency between subscales and strong convergent validity with other measures were demonstrated. Notably, the NPSS Body Concern subscale demonstrated high convergence with other popular measures of body dissatisfaction and has the potential for use as a brief measure of body dissatisfaction among North American Asian females in clinical and research settings.

CONCLUSIONS

The NPSS provides a valid assessment of body dissatisfaction among a sample of Asian women living in Canada, a specific subpopulation that has not been previously investigated. The findings highlight the importance of developing culturally sensitive measures of body dissatisfaction for differing ethnic and cultural groups.

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.

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.

Modern Machiavelli? The illusion of ChatGPT-generated patient reviews in plastic and aesthetic surgery based on 9000 review classifications

BACKGROUND

Online patient reviews are crucial in guiding individuals who seek plastic surgery, but artificial chatbots pose a threat of disseminating fake reviews. This study aimed to compare real patient feedback with ChatGPT-generated reviews for the top five US plastic surgery procedures.

METHODS

Thirty real patient reviews on rhinoplasty, blepharoplasty, facelift, liposuction, and breast augmentation were collected from RealSelf and used as templates for ChatGPT to generate matching patient reviews. Prolific users (n = 30) assessed 150 pairs of reviews to identify human-written and artificial intelligence (AI)-generated reviews. Patient reviews were further assessed using AI content detector software (Copyleaks AI).

RESULTS

Among the 9000 classification tasks, 64.3% and 35.7% of reviews were classified as authentic and fake, respectively. On an average, the author (human versus machine) was correctly identified in 59.6% of cases, and this poor classification performance was consistent across all procedures. Patients with prior aesthetic treatment showed poorer classification performance than those without (p < 0.05). The mean character count in human-written reviews was significantly higher (p < 0.001) that that in AI-generated reviews, with a significant correlation between character count and participants' accuracy rate (p < 0.001). Emotional timbre of reviews differed significantly with "happiness" being more prevalent in human-written reviews (p < 0.001), and "disappointment" being more prevalent in AI reviews (p = 0.005). Copyleaks AI correctly classified 96.7% and 69.3% of human-written and ChatGPT-generated reviews, respectively.

CONCLUSION

ChatGPT convincingly replicates authentic patient reviews, even deceiving commercial AI detection software. Analyzing emotional tone and review length can help differentiate real from fake reviews, underscoring the need to educate both patients and physicians to prevent misinformation and mistrust.

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

Objective

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

Methodology

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

Results

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

Discussions

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

Acceptance and Attitude Toward Cosmetic Surgeries in the Western Region of Saudi Arabia: A Cross-Sectional Survey

Cosmetic surgery refers to any surgical intervention that alters normal bodily characteristics in order to attain a more appealing appearance as perceived by the patient. Data from the American Society of Plastic Surgeons (ASPS) indicates a consistent rise in plastic surgery procedures over time. The objective of our research is to carry out a cross-sectional investigation to assess the perceptions and attitudes toward cosmetic surgery among individuals residing in the western region of Saudi Arabia. This study employed a descriptive, cross-sectional methodology. The intended sample includes residents of Makkah and Medina Regions who are 18 years of age or older, representing the general population. Data collection was carried out through an online questionnaire created using Google Forms, which was disseminated electronically via social media platforms. The questionnaire gathered demographic information and assessed participants' attitudes and acceptance towards cosmetic surgery. The study included a total of 1249 participants, with 1064 (85%) being female and 185 (15%) being male. In our sample, the overall acceptance rate for cosmetic surgery was 54.2%. There was a significant correlation between the acceptance level and factors such as gender, age, marital status, and occupational status (P value <0.001) for all the aforementioned factors. However, the level of education and financial status were not significantly associated. The majority of the participants in our study were accepting of cosmetic surgery. However, to gain a more comprehensive understanding of the acceptance of aesthetic surgery in Saudi Arabia, further research should be conducted across the country to assess the attitudes of the wider population.

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

Background

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

Objectives

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

Methods

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

Results

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

Conclusions

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

Level of Evidence 4

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

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

Psychometric properties of a Romanian translation of the Acceptance of Cosmetic Surgery Scale (ACSS): An examination using bifactor exploratory structural equation modelling

The Acceptance of Cosmetic Surgery Scale (ACSS; Henderson-King & Henderson-King, 2005) is a widely used measure for the assessment of attitudes toward cosmetic surgery. Here, we examined the psychometrics of a novel Romanian translation of the ACSS. A total of 1275 Romanian adults (889 women, 386 men) completed the ACSS alongside additional, related measures. Exploratory factor analysis (EFA) with a first split-half subsample supported extraction of the original 3-factor model consisting of Intrapersonal, Social, and Consider dimensions. In a second split-half subsample, we found that a 3-factor bifactor exploratory structural equation model (B-ESEM) had superior fit compared to all alternative models that were tested. This B-ESEM representation had well-defined G-factor with adequate composite reliability, and its S-factors were also generally well-defined. Across subsamples, the optimal model showed strong or partial strong invariance across gender, with women having significantly higher latent means on the Consider factor relative to men. Evidence of convergent validity was also generally good in women, especially for the G-factor of the ACSS, but was attenuated in men. Overall, these findings indicate that the Romanian version of the ACSS has adequate psychometric properties. We also encourage scholars to consider B-ESEM representations of the ACSS in other national settings.

Direct and Indirect Roles of Men in Determining Women Decision to Use Laser Procedures for Skin Care

Laser procedures for skin care is becoming increasingly popular and used by the global community and affect many aspects of human life. However, there is very little research on the role of men in women's decision to follow this dermatological procedure. This study aimed to identify the role of men in motivating women to choose laser-based procedure. A systematic literature review research design was applied in this study. A total of 27 papers were obtained by searching PubMed Central for the 2013-2022 editions. The extraction of samples and the motivation of patients or research respondents in choosing laser procedures for cosmetic treatments were conducted to obtain clues about the role of men in making these decisions. Only six studies explicitly reveal the role of men as motivators of women to perform laser-based dermatological procedures. Four of these six studies were conducted in Asia in countries with a high degree of collectivism. The remaining two studies reveal a minor role for men in women's motivation to choose dermatological procedures. Other studies only indirectly implicate the role of men through intrasexual competition, increased self-esteem, and the needs of the world of work. Limitations of the study lies in the non-specificity of the study sample in the female population, laser-based treatments, and the role of men in motivating women. The role of men in motivating women to perform laser-based skin care procedures is stated explicitly in collectivist cultures while only implicitly in individualist cultures. These findings indicate that the strategy of utilizing the added value of men to laser treatment procedures should be directed at the relationship between men and women in real terms in collective cultured countries.