Do we really need to change ourselves to be beautiful?

· by · in body dissatisfaction, body dysmorphia, body dysmorphic disorder, body image, Commentary, cosmetic surgery, diversity, dysmorphophobia, healthcare, medicine, mental health, summer, Uncategorized. ·

by Liv Hog

Graduate Student in Psychology, specializing in Cognitive Neuroscience, Ruhr-Universität Bochum, Germany and CEED Summer Fellow 2023

The cosmetic procedure industry has experienced an expansion with procedures becoming increasingly popular and accessible. According to the International Survey on Aesthetic/Cosmetic Procedures (ISAPS), the total number of procedures increased by 19.3% in 2021 compared with 2020. Interest in cosmetic procedures is not limited by geography but has become a worldwide phenomenon. Women comprise the majority of clients in cosmetic procedure settings, accounting for 86% of all procedures. Although the majority of clients are of legal age, certain procedures, such as rhinoplasties (nose jobs) and non-surgical fat reductions, are regularly performed on patients age 18 or younger.1 Procedures conducted for the sole reason to “enhance” physical appearance are documented to be as safe as curative medicine; 2-3 however, they are not free from risk (e.g., blood vessel damage, muscle paralysis, disfiguration) 4-5 and—most importantly—they are not necessary to remain in good health.

So what factors motivate an individual to consider a cosmetic procedure?

  1. Individuals displaying body-dysmorphic symptoms (distress about perceived flaws in appearance not visible to others) are overrepresented in cosmetic procedure settings.6-7Accordingly, body and appearance dissatisfaction have been repeatedly found to contribute to the consideration of a cosmetic procedure in women and men.8-13
  2. Peer pressure also influences whether a person considers a cosmetic procedure. Individuals who report more appearance-based conversations among friends and family, 10,14 and who have suffered from peer victimization based on their appearance12 report higher intentions of having a cosmetic procedure.
  3. Broadcast media, such as television, was found to fuel the desire to undergo a cosmetic procedure. Viewing cosmetic surgery related or appearance related TV shows8,15-16 as well as exposure to cosmetic surgery advertising 17 increase body dissatisfaction which, in turn, is positively correlated with the acceptance of and interest in cosmetic procedures.
  4. Time spent on social media and viewing material related to cosmetic surgery were shown to increase the acceptance and consideration of cosmetic procedures.9,18 -19 Recently, the role of “selfie” behavior has come into focus. Taking and posting selfies was found to be related to the consideration of a cosmetic procedure20-21 as was the common practice of selfie editing.22-23

The cosmetic procedure industry profits from appearance-related insecurities.24 To be sure, some evidence exists for increased self-esteem and body satisfaction among clients after cosmetic surgery.25-26 However, the mere existence of such an industry pathologizes normal variations in appearance, conveys the necessity to change oneself to meet certain appearance ideals,27 and contributes to poor body image. 24 Poor body image is a public health concern and is known to result in adverse health outcomes such as drug use; self-harm;28 impairment in psychological well-being (e.g., depression); and problems associated with eating, weight, and shape (e.g., eating disorders, obesity).29-30 Craddock et al. (2022) interviewed fourteen senior cosmetic procedure professionals from the UK and reported a lack of insight regarding the industry’s responsibilities in relation to poor body image.31

Whether a person wants to undergo a cosmetic procedure is a deeply personal decision. Nevertheless, professionals involved with cosmetic procedures should be able to think beyond profits to identify and refer patients whose motivation may be rooted in treatable mental illnesses. Furthermore, the industry should increase awareness of its social responsibility. It is challenging to completely free ourselves from the societal pressure to meet certain appearance ideals; however, we can ask ourselves whether it is necessary to undergo cosmetic procedures in order to be at peace with our appearance or to feel beautiful.

References

  1. ISAPS International Survery on Aesthetic/Cosmetic Procedures Performed in 2021. Retrieved July 21, 2023, from https://www.isaps.org/media/vdpdanke/isaps-global-survey_2021.pdf
  2. Gupta, V., Winocour, J., Shi, H., Shack, R. B., Grotting, J. C., & Higdon, K. K. (2016). Preoperative Risk Factors and Complication Rates in Facelift: Analysis of 11,300 Patients. Aesthetic Surgery Journal, 36(1), 1–13. https://doi.org/10.1093/asj/sjv162
  3. Layliev, J., Gupta, V., Kaoutzanis, C., Ganesh Kumar, N., Winocour, J., Grotting, J. C., & Higdon, K. K. (2017). Incidence and Preoperative Risk Factors for Major Complications in Aesthetic Rhinoplasty: Analysis of 4978 Patients. Aesthetic Surgery Journal, 37(7), 757–767. https://doi.org/10.1093/asj/sjx023
  4. Cárdenas-Camarena, L., Bayter, J. E., Aguirre-Serrano, H., & Cuenca-Pardo, J. (2015). Deaths Caused by Gluteal Lipoinjection: What Are We Doing Wrong? Plastic and Reconstructive Surgery, 136(1), 58–66. https://doi.org/10.1097/PRS.0000000000001364
  5. Emer, J., & Levy, L. (2012). Complications of minimally invasive cosmetic procedures: Prevention and management. Journal of Cutaneous and Aesthetic Surgery, 5(2), 121. https://doi.org/10.4103/0974-2077.99451
  6. Bowyer, L., Krebs, G., Mataix-Cols, D., Veale, D., & Monzani, B. (2016). A critical review of cosmetic treatment outcomes in body dysmorphic disorder. Body Image, 19, 1–8. https://doi.org/10.1016/j.bodyim.2016.07.001
  7. Sarwer, D. B., & Spitzer, J. C. (2012). Body Image Dysmorphic Disorder in Persons Who Undergo Aesthetic Medical Treatments. Aesthetic Surgery Journal, 32(8), 999–1009. https://doi.org/10.1177/1090820X12462715
  8. Sharp, G., Tiggemann, M., & Mattiske, J. (2014). The role of media and peer influences in Australian women’s attitudes towards cosmetic surgery. Body Image, 11(4), 482–487. https://doi.org/10.1016/j.bodyim.2014.07.009
  9. Abbas, O. L., & Karadavut, U. (2017). Analysis of the Factors Affecting Men’s Attitudes Toward Cosmetic Surgery: Body Image, Media Exposure, Social Network Use, Masculine Gender Role Stress and Religious Attitudes. Aesthetic Plastic Surgery, 41(6), 1454–1462. https://doi.org/10.1007/s00266-017-0882-3
  10. Matera, C., Nerini, A., & Stefanile, C. (2018). Why are men interested in cosmetic surgery procedures? Examining the role of different forms of peer influence, social comparison, internalization, and body dissatisfaction. Body Image, 26, 74–77. https://doi.org/10.1016/j.bodyim.2018.06.003
  11. Nerini, A., Matera, C., Di Gesto, C., Policardo, G. R., & Stefanile, C. (2019). Exploring the Links Between Self-Compassion, Body Dissatisfaction, and Acceptance of Cosmetic Surgery in Young Italian Women. Frontiers in Psychology, 10, 2698. https://doi.org/10.3389/fpsyg.2019.02698
  12. Javo, I. M., & Sørlie, T. (2010). Psychosocial Predictors of an Interest in Cosmetic Surgery among Young Norwegian Women: A Population-Based Study. Plastic Surgical Nursing, 30(3), 180–186. https://doi.org/10.1097/PRS.0b013e3181bcf290
  13. Von Soest, T., Kvalem, I. L., Skolleborg, K. Chr., & Roald, H. E. (2006). Psychosocial Factors Predicting the Motivation to Undergo Cosmetic Surgery: Plastic and Reconstructive Surgery, 117(1), 51–62. https://doi.org/10.1097/01.prs.0000194902.89912.f1
  14. Nerini, A., Matera, C., & Stefanile, C. (2014). Psychosocial Predictors in Consideration of Cosmetic Surgery Among Women. Aesthetic Plastic Surgery, 38(2), 461–466. https://doi.org/10.1007/s00266-014-0294-6
  15. Sperry, S., Thompson, J. K., Sarwer, D. B., & Cash, T. F. (2009). Cosmetic Surgery Reality TV Viewership: Relations With Cosmetic Surgery Attitudes, Body Image, and Disordered Eating. Annals of Plastic Surgery, 62(1), 7–11. https://doi.org/10.1097/SAP.0b013e31817e2cb8
  16. Markey, C. N., & Markey, P. M. (2010). A correlational and experimental examination of reality television viewing and interest in cosmetic surgery. Body Image, 7(2), 165–171. https://doi.org/10.1016/j.bodyim.2009.10.006
  17. Ashikali, E.-M., Dittmar, H., & Ayers, S. (2017). The impact of cosmetic surgery advertising on women’s body image and attitudes towards cosmetic surgery. Psychology of Popular Media Culture, 6(3), 255–273. https://doi.org/10.1037/ppm0000099
  18. Arab, K., Barasain, O., Altaweel, A., Alkhayyal, J., Alshiha, L., Barasain, R., Alessa, R., & Alshaalan, H. (2019). Influence of Social Media on the Decision to Undergo a Cosmetic Procedure. Plastic and Reconstructive Surgery – Global Open, 7(8), e2333. https://doi.org/10.1097/GOX.0000000000002333
  19. Walker, C. E., Krumhuber, E. G., Dayan, S., & Furnham, A. (2021). Effects of social media use on desire for cosmetic surgery among young women. Current Psychology, 40(7), 3355–3364. https://doi.org/10.1007/s12144-019-00282-1
  20. Lyu, Z., Jiao, Y., Zheng, P., & Zhong, J. (2022). Why do selfies increase young women’s willingness to consider cosmetic surgery in China? The mediating roles of body surveillance and body shame. Journal of Health Psychology, 27(5), 1205–1217. https://doi.org/10.1177/1359105321990802
  21. Shome, D., Vadera, S., Male, S. R., & Kapoor, R. (2020). Does taking selfies lead to increased desire to undergo cosmetic surgery. Journal of Cosmetic Dermatology, 19(8), 2025–2032. https://doi.org/10.1111/jocd.13267
  22. Wang, Y., Chu, X., Nie, J., Gu, X., & Lei, L. (2022). Selfie-editing, facial dissatisfaction, and cosmetic surgery consideration among Chinese adolescents: A longitudinal study. Current Psychology, 41(12), 9027–9037. https://doi.org/10.1007/s12144-020-01
  23. Sun, Q. (2021). Selfie Editing and Consideration of Cosmetic Surgery Among Young Chinese Women: The Role of Self-Objectification and Facial Dissatisfaction. Sex Roles, 84(11–12), 670–679. https://doi.org/10.1007/s11199-020-01191-5
  24. Widdows, H. (2018). Perfect Me: Beauty as an Ethical Ideal. Princeton University Press. https://doi.org/10.23943/9781400889624
  25. Esmalian Khamseh, L. & Nodargahfard, M., (2020). The Effect of Cosmetic Surgery on Sexual Self-Esteem: Attitudes toward Body Image and Well-Being in Married Women. World Journal  of Plastic Surgery, 9(2), 153–159. https://doi.org/10.29252/wjps.9.2.153
  26. Von Soest, T., Kvalem, I. L., Skolleborg, K. C., & Roald, H. E. (2011). Psychosocial Changes after Cosmetic Surgery: A 5-Year Follow-Up Study. Plastic and Reconstructive Surgery, 128(3), 765–772. https://doi.org/10.1097/PRS.0b013e31822213f0
  27. Bonell, S., Austen, E., & Griffiths, S. (2022). Australian women’s motivations for, and experiences of, cosmetic surgery: A qualitative investigation. Body Image, 41, 128–139. https://doi.org/10.1016/j.bodyim.2022.02.010
  28. Bornioli, A., Lewis-Smith, H., Smith, A., Slater, A., & Bray, I. (2019). Adolescent body dissatisfaction and disordered eating: Predictors of later risky health behaviours. Social Science & Medicine, 238, 112458. https://doi.org/10.1016/j.socscimed.2019.112458
  29. M. Bucchianeri, M., & Neumark-Sztainer, D. (2014). Body dissatisfaction: An overlooked public health concern. Journal of Public Mental Health, 13(2), 64–69. https://doi.org/10.1108/JPMH-11-2013-0071
  30. Griffiths, S., Hay, P., Mitchison, D., Mond, J. M., McLean, S. A., Rodgers, B., Massey, R., & Paxton, S. J. (2016). Sex differences in the relationships between body dissatisfaction, quality of life and psychological distress. Australian and New Zealand Journal of Public Health, 40(6), 518–522. https://doi.org/10.1111/1753-6405.12538
  31. Craddock, N., Spotswood, F., Rumsey, N., & Diedrichs, P. C. (2022). “We should educate the public that cosmetic procedures are as safe as normal medicine”: Understanding corporate social responsibility from the perspective of the cosmetic procedures industry. Body Image, 43, 75–86. https://doi.org/10.1016/j.bodyim.2022.08.011