research topics in cosmetic surgery

Insights in Reconstructive and Plastic Surgery: 2022

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Articles on Cosmetic surgery

Displaying 1 - 20 of 44 articles.

Undergoing cataract surgery when it’s not necessary? Some do it to improve their eyesight, but it’s not without risk

Langis Michaud , Université de Montréal

Thinking about cosmetic surgery? New standards will force providers to tell you the risks and consider if you’re actually suitable

Gemma Sharp , Monash University

‘Bone smashing’: broken bones, tooth loss and blood vessel damage are just a few of the harms of this bizarre TikTok trend

Adam Taylor , Lancaster University

Cosmetic surgery boosts some people’s mental health – but for others it makes problems worse

Viren Swami , Anglia Ruskin University

Botox and fillers to come under greater scrutiny by the medical regulator. Will it be too little too late?

Christopher Rudge , University of Sydney

Beauty procedures from manicures to cosmetic surgery carry risk — and the reward of a better life — podcast

Nehal El-Hadi , The Conversation and Daniel Merino , The Conversation

Beauty ideals were as tough in the middle ages as they are now

Laura Kalas , Swansea University

Doctors may soon get official ‘endorsements’ to practise cosmetic surgery – but will that protect patients?

Thinking about cosmetic surgery? At last, some clarity on who can call themselves a surgeon

Christopher Rudge , University of Sydney and Cameron Stewart , University of Sydney

What’s the connection between cosmetic procedures and mental health?

Gemma Sharp , Monash University and Nichola Rumsey , University of the West of England

Who’s the best doctor for a tummy tuck or eyelid surgery? The latest review doesn’t actually say

Linda Evangelista says fat freezing made her a recluse. Cryolipolysis can do the opposite to what’s promised

Michael Freeman , Bond University

Thinking of getting a minor cosmetic procedure like botox or fillers? Here’s what to consider first

Simone Buzwell , Swinburne University of Technology ; Gemma Sharp , Monash University ; Susan Rossell , Swinburne University of Technology , and Toni Pikoos , Swinburne University of Technology

This 400-year -old botched nose job shows how little our feelings about transplants have changed

Alanna Skuse , University of Reading

Friday essay: how 19th century ideas influenced today’s attitudes to women’s beauty

Michelle Smith , Monash University

What do normal labia look like? Sometimes doctors are the wrong people to ask

Maggie Kirkman , Monash University

Brazilian butt lifts are the deadliest of all aesthetic procedures – the risks explained

Jim Frame , Anglia Ruskin University

In Brazil, patients risk everything for the ‘right to beauty’

Carmen Alvaro Jarrin , College of the Holy Cross

Why are fewer and fewer Americans fixing their noses?

Laurie Essig , Middlebury

Beyond #MeToo, Brazilian women rise up against racism and sexism

Carmen Alvaro Jarrin , College of the Holy Cross and Kia Lilly Caldwell , University of North Carolina at Chapel Hill

Related Topics

• Beauty standards
• Cosmetic procedures
• cosmetic surgery guidelines
• Health regulation
• Plastic surgery

Top contributors

Law lecturer, University of Sydney

Professor of Aesthetic Plastic Surgery, Anglia Ruskin University

Associate Professor in Literary Studies, Monash University

Associate Professor, NHMRC Emerging Leadership Fellow & Senior Clinical Psychologist, Monash University

Associate Professor of Anthropology, College of the Holy Cross

Professor at Sydney Law School, University of Sydney

Professor of Medical Education (Patient Safety), University of Sydney

Professor of Gender and Culture, University of Leeds

Lecturer, Gender Studies program, School of Social and Political Sciences, The University of Melbourne

Clinical Lecturer, Anaesthetist, The University of Melbourne

Academic Convenor, MAEVe ( Melbourne Alliance to End Violence against women and their children, The University of Melbourne

Director Clinical Trials and Professor Cognitive Neuropsychiatry Centre for Mental Health and Brain Sciences, Swinburne University of Technology

Lecturer, University of Leicester

Professor, College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University

Professor of Sociology in the School of Social Sciences, Monash University

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Facial Plastic and Reconstructive Surgery

At the Johns Hopkins Center for Facial Plastic and Reconstructive Surgery, research is the mainstay of what we do. Whether it is clinical outcomes studies, surgical innovations or bench to patient translational research, our clinician scientists are leaders in their field and among the best in the world. Our research is problem-driven and focuses on discovering new and better solutions for our patients.

Our research is critical because it allows us to make the jump from what we learn to improved and advanced surgical techniques. Dr. Lisa Ishii

Areas of research focus include:

• Blink efficiency in facial paralysis
• Predicting Facial muscle recovery in partial and complete facial paralysis
• Functional omohyoid muscle for smile and blink restoration
• Selective myectomy for facial synkinesis
• Detecting occult neoplasm in facial paralysis
• Facial paralysis in neurofibromatosis
• Facial weakness and restoration in facioscapulohumeral muscular dystrophy (FSHD)
• Multi-vector gracilis functional muscle transfer for smile and blink restoration
• Reconfiguration of the facial neural network
• Optimizing facial paralysis outcomes in the elderly
• Functional trachea engineered on a thermoplastic scaffold
• Towards a hybrid biologic ear construct
• Laminated and prelaminated forehead flaps
• Thermoplastic structured total nasal reconstruction
• Assessing gaze patterns in facial cosmetic and reconstructive surgery
• Exploring the facial cues of age in a tasked eye-tracking study
• Societal identification of facial paralysis and paralysis location
• Versatile application of vastus lateralis-circumflex femoral artery-based flap in head and neck reconstruction
• Multi-vector functional muscle tendon transplantation
• Functional omohyoid flap
• Multi-segmented fibular osteocutaneous flap in midfacial reconstruction
• Vascularized tissue transplant is osteoradionecrosis
• Targeted out-patient boutique flaps in head and neck reconstruction
• Optimizing function reconstruction for total glossectomy (tongue) reconstruction
• Predicting flap volume changes following microvascular transfer
• Advances in diagnostics, artistry, and surgical techniques
• Sports trauma

We offer extensive opportunities for collaboration with private companies seeking clinical trials.

Collaborative research projects are available for interested researchers, including postdocs, residents, and students, as well as foreign medical graduates.

Restoring Facial Expressions – Dr. Kofi Boahene

Dr. Kofi Boahene focuses his career on restoring facial movement and expression to those who suffer from facial paralysis.

Selected Publications

Facial nerve and facial paralysis.

• Boahene KD. Principles and biomechanics of muscle tendon unit transfer: application in temporalis muscle tendon transposition for smile improvement in facial paralysis. Laryngoscope. 2013;123(2):350-355.
• Boahene KO, Owusu J, Ishii L, et al. The Multivector Gracilis Free Functional Muscle Flap for Facial Reanimation. JAMA Facial Plast Surg. 2018;20(4):300-306.
• Lee AH, Han Liu R, Ishii LE, et al. Free Functional Gracilis Flaps for Facial Reanimation in Elderly Patients. Facial Plast Surg Aesthet Med. 2020.
• Revenaugh PC, Smith RM, Plitt MA, Ishii L, Boahene K, Byrne PJ. Use of Objective Metrics in Dynamic Facial Reanimation: A Systematic Review. JAMA Facial Plast Surg. 2018;20(6):501-508.
• Dey JK, Ishii LE, Byrne PJ, Boahene KD, Ishii M. Seeing is believing: objectively evaluating the impact of facial reanimation surgery on social perception. Laryngoscope. 2014;124(11):2489-2497.

Tissue Engineering

• Lee LN, Boahene KD. A novel technique for sculpting costal cartilage in microtia repair and rhinoplasty. JAMA Facial Plast Surg. 2013;15(5):349-351.
• Chen D, Britt CJ, Mydlarz W, Desai SC. A novel technique for tracheal reconstruction using a resorbable synthetic mesh. Laryngoscope. 2018;128(7):1567-1570.
• Desai SC. Is e-Cigarette Vaping a New Clinical Challenge to Wound Healing? JAMA Facial Plast Surg. 2019;21(1):10-11.

Complex Nasal Reconstruction

• Brissett AE, Ishii LE, Boahene KDO. Ethnically Sensitive Rhinoplasty. Otolaryngol Clin North Am. 2020;53(2):xiii-xiv.
• Smith DF, Albathi M, Lee A, Lee LN, Boahene KD. Upper lateral cartilage composite flap for closure of complicated septal perforations. Laryngoscope. 2017;127(8):1767-1771.
• Kumar AR, Ishii M, Papel I, et al. The Health Utility and Valuation of Cosmetic Rhinoplasty. Facial Plast Surg Aesthet Med. 2020;22(4):268-273.

Facial Expression and Perception Research

• Bater KL, Ishii LE, Papel ID, et al. Association Between Facial Rejuvenation and Observer Ratings of Youth, Attractiveness, Success, and Health. JAMA Facial Plast Surg. 2017;19(5):360-367.
• Dey JK, Ishii LE, Boahene KDO, Byrne PJ, Ishii M. Measuring Outcomes of Mohs Defect Reconstruction Using Eye-Tracking Technology. JAMA Facial Plast Surg. 2019;21(6):518-525.
• Godoy A, Ishii M, Byrne PJ, Boahene KD, Encarnacion CO, Ishii LE. The straight truth: measuring observer attention to the crooked nose. Laryngoscope. 2011;121(5):937-941.
• Ishii LE, Nellis JC, Boahene KD, Byrne P, Ishii M. The Importance and Psychology of Facial Expression. Otolaryngol Clin North Am. 2018;51(6):1011-1017.
• Nellis JC, Ishii M, Papel ID, et al. Association of Face-lift Surgery With Social Perception, Age, Attractiveness, Health, and Success. JAMA Facial Plast Surg. 2017;19(4):311-317.
• Roxbury C, Ishii M, Godoy A, et al. Impact of crooked nose rhinoplasty on observer perceptions of attractiveness. Laryngoscope. 2012;122(4):773-778.
• Chen J, Ishii M, Bater KL, et al. Association Between the Use of Social Media and Photograph Editing Applications, Self-esteem, and Cosmetic Surgery Acceptance. JAMA Facial Plast Surg. 2019;21(5):361-367.

Microsurgical Tissue Transplantation

• Britt CJ, Hwang MS, Day AT, et al. A Review of and Algorithmic Approach to Soft Palate Reconstruction. JAMA Facial Plast Surg. 2019;21(4):332-339.
• Kim IA, Boahene KD, Byrne PJ, Desai SC. Microvascular Flaps in Nasal Reconstruction. Facial Plast Surg. 2017;33(1):74-81.
• Desai SC, Seth R. Shifting Paradigms in Head and Neck Reconstructive Surgery During the COVID-19 Crisis. Facial Plast Surg Aesthet Med. 2020;22(3):152-154.
• Rabbani CC, Hwang MS, Byrne PJ, Desai SC. Management of Large Facial Defects. Facial Plast Surg. 2020;36(2):148-157.

Hair Loss and Restorative Research

• Kumar AR, Ishii LE. Hair Transplantation for Scarring Alopecia. Facial Plast Surg Clin North Am. 2020;28(2):177-179.

Sports Trauma

• Boahene KD, Brissett AE. Contemporary management of facial trauma. Otolaryngol Clin North Am. 2013;46(5):xi-xii.
• Owusu JA, Boahene K. Update of patient-specific maxillofacial implant. Curr Opin Otolaryngol Head Neck Surg. 2015;23(4):261-264.

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• v.20(4); Winter 2012

Language: English | French

Factors that motivate people to undergo cosmetic surgery

A sample of 204 British participants completed a questionnaire that assessed their attitude toward cosmetic surgery as well as measures of self-esteem, life satisfaction, self-rated physical attractiveness, religiosity and media consumption. Two factors emerged from a factor analysis of their attitudes toward surgery: likelihood to undergo, and benefits of undergoing, cosmetic surgery. Females with low self-esteem, low life satisfaction, low self-rated attractiveness and little religious beliefs who were heavy television watchers reported a greater likelihood of undergoing cosmetic surgery. Stepwise regression analysis with the two attitude factors as criterion variables showed two major predictors for likelihood: religiousness and low self-esteem, and four major predictors for benefit: religousness, media consumption, life satisfaction and sex. The role of religion is considered in this context.

Un échantillon de 204 participants britannique ont rempli un questionnaire qui évaluait leur attitude envers la chirurgie plastique et contenait des mesures d’estime de soi, de satisfaction envers la vie, d’attirance physique autoévaluée, de religiosité et de consommation des médias. Deux facteurs ont émergé d’une analyse factorielle de leurs attitudes envers la chirurgie : la probabilité et les avantages de subir une chirurgie. Les femmes ayant une faible estime de soi, une satisfaction peu élevée envers la vie, une faible attirance physique autoévaluée et peu de convictions religieuses qui regardaient beaucoup la télévision étaient les plus susceptibles de subir une chirurgie esthétique. Une analyse de régression échelonnée faisant appel aux deux facteurs d’attitude comme variables de critère a révélé deux grands prédicteurs de probabilité : la religiosité et la faible estime de soi, et quatre grands prédicteurs d’avantages : la religiosité, la consommation des médias, la satisfaction envers la vie et l’activité sexuelle. Le rôle de la religion est examiné dans ce contexte.

The role of attractiveness in Western society has been extensively explored by evolutionary and social psychologists ( 1 – 3 ). A meta-analysis of more than 900 studies by Langlois et al ( 4 ) provides further support that people are treated differently based on how physically attractive they are perceived to be. Given the influence that physical attractiveness has in our everyday lives, it is perhaps not surprising that people seek a means to alter their appearance to conform to societal ideals of attractiveness. The present study investigated attitudes toward cosmetic surgery by replicating and extending three studies in this area ( 5 – 7 ). The focus of the present study was on how media consumption and religious beliefs, in addition to self-esteem and life satisfaction, influence attitudes to cosmetic surgery.

Cosmetic surgery is concerned with the “maintenance, restoration or enhancement of one’s physical appearance through surgical and medical techniques” ( 7 ). The American Society for Aesthetic Plastic Surgery reported an increase of 446% in cosmetic procedures since 1997 and an overall increase of 8% in 2007, with a 17% increase in men undertaking cosmetic surgery ( 8 ). This increase is similar in the United Kingdom. The British Association of Plastic Surgeons recorded a 35% increase in procedures performed by its members from 2004 to 2005 ( 9 ). With the increased prevalence, accessibility and evolution of cosmetic surgery in Western society, it is becoming increasingly relevant to explore the various internal and external factors that motivate people to undergo cosmetic surgery. Sarwer et al ( 10 ) attribute this recent increase to the availability of plastic surgeons, the influence of the media, evolutionary interests and personal factors relating to the patient. The technological advances in cosmetic surgery have made it safer and less invasive, with a faster recovery time, as well as lowering the cost of procedures. Thus, people have become less anxious, and more willing to consider and accept cosmetic surgery as a possible option for altering their physical appearance ( 11 ).

The decision to seek out plastic surgery has recently attracted a significant amount of attention ( 12 – 14 ). Studies have focused on evolutionary, psychosocial and health behavioural covariates of those who have undergone cosmetic surgery ( 15 ), as well as more attitudinal and belief system factors such as life satisfaction, self-esteem and body image ( 16 ). A comprehensive review by Ching et al ( 17 ) found a patient’s body image and perceived quality of life to be the strongest and most consistent determinants of aesthetic surgery outcomes. The present study focused on two factors previously disregarded in this literature: media consumption and religious beliefs.

Markey and Markey ( 18 ) recently examined young American women’s interest in obtaining cosmetic surgery. They found that all four factors they investigated – namely, body dissatisfaction, physical appearance, teasing (being teased about 11 different body parts) and media influence (feeling pressured to appear like people in the media) – were related to the desire to have cosmetic surgery. The best predictor of their interest in obtaining cosmetic surgery was body dissatisfaction, which has been investigated extensively.

The majority of studies exploring the reasons one may have for undertaking cosmetic surgery have focused on patient samples. There is a noticeable lack of research focusing on nonpatient samples. Delinsky ( 13 ) found that media exposure and vicarious experience predicted a greater likelihood of undergoing cosmetic surgery. Similarly, Brown et al ( 5 ) found that vicarious experience of cosmetic surgery increased the likelihood of undergoing cosmetic surgery for women. Their results also suggested that women are more likely to undergo cosmetic surgery than men, and that older men report less desire to undergo cosmetic surgery than younger men. Furthermore, contrary to Delinsky’s findings, they found that media exposure did not influence the likelihood of undergoing cosmetic surgery for either sex. They accounted for this finding by suggesting that the saturation of media sources with cosmetic surgery messages has caused awareness to reach a peak ( 5 ). Thus, they suggest that the effect of media influence is no longer as pronounced as it once was. This finding, however, needs to be replicated in a different culture.

Sarwer et al ( 10 ) proposed that the growing awareness of this beauty bias is partly responsible for the increased number of people altering their appearance through cosmetic procedures. This awareness may cause some individuals to attribute their low life satisfaction to their physical appearance and seek cosmetic alteration as a consequence. Related to life satisfaction is self-esteem, which previous studies have shown to be negatively associated with the likelihood of having cosmetic surgery ( 7 ). Swami et al ( 7 ) also showed a strong correlation with participants’ self-rated attractiveness and self-esteem. The trait variable of openness was consistently negatively associated with acceptance of cosmetic surgery.

The increasing number of television programmes concerning cosmetic surgery, both fact and fiction, has increased public awareness of the benefits it can offer and has mainstreamed society’s awareness of cosmetic procedures ( 19 ). Crockett et al ( 20 ) showed that cosmetic surgery reality television plays a significant role in cosmetic surgery patient perceptions and decision making. Patients who watched a considerable amount of cosmetic surgery reality shows reported a greater influence from television and media to have cosmetic surgery, compared with low-intensity viewers. High-intensity viewers felt more knowledgeable about cosmetic surgery in general and believed that cosmetic surgery reality television was more similar to real life than did low-intensity viewers.

Research exploring religiosity as a possible factor predicting the likelihood of undergoing cosmetic surgery is sparse. Previous research has shown that religiosity significantly predicts attitudes toward controversial topics in Western society such as abortion ( 21 ), genetic screening ( 22 ) and euthanasia ( 23 ). It is also suggested that religiously conservative individuals of all faiths will have stricter views about ‘deception’ and sins of vanity. and will be less likely to undergo cosmetic surgery than more liberal or atheist individuals.

The current study aimed to expand the knowledge concerning the spectrum of reasons one may have for undergoing cosmetic surgery. It is an extension and partial replication of the studies by Brown et al ( 5 ) and Swami et al ( 6 ), focusing on the role of media consumption. Three hypotheses of the current study attempt to replicate previous findings: women will be more likely to have cosmetic surgery than men; lower self-ratings of attractiveness will predict the likelihood of undergoing cosmetic surgery; and lower ratings of self-esteem and life satisfaction will be associated with the likelihood of having cosmetic surgery. Two hypotheses are unique to the study: higher (general) media exposure will predict the likelihood of considering having surgery; and highly religious subjects will be less likely to consider cosmetic surgery than less religious subjects.

Participants

A total of 204 individuals (90 men, 114 women) ranging in age from 18 to 74 years (mean [± SD] age 34.73±16.14 years) participated in the present study. Most of the participants were of European Caucasian descent (67.2%), but other ethnic groups were also represented including Asian (12.3%) and Afro-Caribbean (2%). They rated their religiosity on a 7-point scale (1 = not at all; 7 = very) with a mean of 3.02±1.72. The majority of participants were either Christian (38.2%) or atheist (38.7%), although some were Buddhist (2.9%) or were of some other religious affiliation (12.3%). In terms of marital status, 31.4% were single, 26% were dating, 32.4% were married and 10.3% were of some other relationship status. Finally, most participants reported never undergoing cosmetic surgery (94.1%).

Likelihood of having cosmetic surgery scale ( 5 ):

Questions assessed the participants’ acceptance of cosmetic surgery (five items) and their likelihood of undergoing cosmetic surgery (10 items) rated on a five-point agree-disagree scale. The two subscales were shown to have high alphas (acceptance: α=0.90, and likelihood: α=0.94).

Self-esteem:

The Rosenberg self-esteem scale ( 24 ) was used to measure participants’ self-worth. The scale consists of 10 items, each of which are rated on a four-point scale (1 = stongly disagree, 4 = strongly agree). The scale had good internal consistency in the current study (α=0.91).

Life satisfaction scale ( 5 ):

This five-item scale measures life satisfaction on a five-point scale (1 = strongly disagree, 5 = strongly agree). Participants were asked to indicate the extent to which they agreed or disagreed with the various statements (eg, ‘In most ways, my life is close to my ideal’). Cronbach’s alpha for this scale was 0.84.

Self-assessed attractiveness ( 25 ):

This part of the questionnaire required participants to rate their overall physical attractiveness, facial attractiveness, body weight or size and body shape or figure. Participants were provided with a bell-curve graph showing the typical distribution of attractiveness scores (M=100±15). Thus, 70 was labelled unattractive, 85 low average, 100 average. This had successfully been used in previous studies ( 7 ). These four items had high internal consistency (α=0.95).

Media exposure:

Media exposure was divided into two sections. First, participants were asked the following questions, which were rated on a five-point scale (1 = never, 5 = very often):

• How often have you seen advertisements for cosmetic surgery? (M=3.61±1.96)
• How often have you read articles or books about cosmetic surgery? (M=2.42±1.53)
• How often have you seen television programmes about cosmetic surgery? (M=3.11±1.05)
• How often have you heard radio programmes about cosmetic surgery? (M=1.74±0.99)
• In general, how often would you say you currently watch television or movies? (M=3.97±1.02)
• In general, how often would you say you currently read magazines? (M=3.02±1.10).

These six items had an alpha of 0.64.

Second, participants were asked about their time spent watching television, reading magazines, listening to podcasts and browsing the Internet, which were rated on a seven-point scale: 1 = ≥4 h; 2 = 2 h to 4 h, 3 = 1 h to <2 h; 4 =≤1 h; 5 = two to three times per week; 6 = once per week; 7 = less often. The following mean scores were recorded: television, M=3.97±1.02; magazines, M=3.02±1.10; pod-casts, M=1.48±1.06; and Internet, M=5.21±1.38. Due to the small number of individuals who reported having heard radio shows on cosmetic surgery, this item was not included in the analysis.

Demographics:

Participants were required to provide demographic data including age, sex, ethnicity, religion, marital status, highest educational qualification and number of siblings. They were also asked to state how religious they were using a seven-point scale (1 = not at all religious, 7 = very religious).

Personal experience:

Participants were asked whether they have ever undergone cosmetic surgery (1 = no, 2 = yes) and given the option to state the procedure. Due to only 11 of the 204 participants (5.4%) reporting having undergone cosmetic surgery, this item was not included in the analysis.

Once ethical approval had been obtained, participants were approached in various places in the British public (eg, libraries, cafes, train stations, churches, universities) by various researchers experienced in this technique. Individuals were briefed about the nature of the study and then offered the opportunity to participate. They were assured that their data would remain completely anonymous. Once they had provided informed consent, they completed the five-page questionnaire, which took approximately 15 min to complete. Participants were debriefed after completing the questionnaire. Of those approached, approximately 70% agreed to participate; the majority of the remainder claimed insufficient time to spare.

Factor analysis

A factor analysis with VARIMAX rotation was performed on the 15-item attitude toward cosmetic surgery scale. The results of the factor analysis are shown in Table 1 . Two factors emerged, labelled: 1) Likelihood of having cosmetic surgery; and 2) Benefits to having cosmetic surgery. The two rotated factors accounted for 66.1% of the variance, with the first factor accounting for 34.8% of this variance.

Sex differences and factor analytic results for the likelihood questionnaire

*** P<0.001;

** P<0.01. Scores were marked on a seven-point scale: Strongly disagree 1 2 3 4 5 6 7 Strongly agree. (R) indicates that the scoring for that item was reversed

Table 1 also shows the results for the fifteen one-way ANOVAs. Slightly less than one-half showed significant differences, which were all in the same direction (women scored lower than men) and nearly all those items that loaded on the second factor. An ANOVA on the two factor scores showed no significant difference on factor 1 (F[1, 202]=0.81) but a highly significant sex difference on factor 2 (F[1, 202]=21.42, P<0.001). Women scored higher than men on the second factor.

Table 2 presents the correlations between the different measures with an emphasis on correlates of factors 1 and 2. Correlations were very similar, with the two-factor scores indicating that those with low self-esteem, life satisfaction, self-rated attractiveness and religiousness but high media consumption were more positive toward cosmetic surgery. The table shows that all hypotheses were confirmed.

Correlations between the major variables

Correlation r>0.20;

Two regressions were performed with each factor score as the criterion variable and four sets of predictor variables: Demographic data (sex and age), were entered first, then religiousness, then self-assessment (self-esteem, life satisfaction, attractiveness) and, finally, media consumption. Table 3 shows the results of the final step in the regressions. The first factor was significant and accounted for nearly 20% of the variance. Demography accounted for no variance, religion 4% of variance, the self-assessment variables 19% of variance and media consumption no variance. It showed that nonreligious people with low self-esteem and low perceived self-attractiveness were most willing to undergo cosmetic surgery. The second factor on the benefits of cosmetic surgery showed the predictor variables accounted for 41% of the variance. The stepwise regression showed that sex accounted for 9% of the variance, religiousness 32%, life satisfaction 3% and media consumption 6%. The regression showed that women, with few religious beliefs, low life satisfaction and high overall media consumption, were more accepting of the benefits of cosmetic surgery.

Regressional analyses

The findings of the current study showed that lower ratings of self-esteem and life satisfaction, increased media exposure to cosmetic surgery via television shows, time spent watching television and religiosity were all significant predictors of the likelihood of undergoing cosmetic surgery. While the correlations between the various measures and the two-factor scores were similar, the regressions showed that different measures predicted the two different factors. The second factor (concerning the benefits of cosmetic surgery) was most strongly predicted by the two unique features of the present study, namely religious beliefs and media consumption.

Both correlations and regressions indicated that, although women were more likely to say they would have surgery, it was the sex difference in perceived benefits (factor 2) that was strongest. The finding that women did not significantly report a greater likelihood of undergoing cosmetic surgery than men is inconsistent with nearly all previous studies ( 5 , 13 ). It was expected that the greater sociocultural pressure on women to conform to societal ideals of attractiveness (shown by the prevalence of body image and eating disorders among women) would serve to normalize their pursuit of cosmetic surgery. Studies have also shown real-life biases for attractive women, and discrimination against less attractive women, in several different domains of society ( 26 , 27 ). Considering these findings, the results of the current study are surprising. Cosmetic surgeons, recognizing the increasing number of men undergoing cosmetic surgery in recent years, may no longer be specifically targeting women in their advertising. Therefore, the contemporary view of cosmetic surgery, as propagated by the media, may in fact account for the unusual findings of the current study.

Confirming the results of Brown et al ( 5 ), it was found that self-ratings of physical attractiveness did have a significant effect on the likelihood of undergoing cosmetic surgery.

The current study showed that self-esteem was negatively associated with the likelihood of undergoing cosmetic surgery. Individuals with low self-esteem may be more willing to have cosmetic alteration to improve their own self-perceptions, thus boosting their self-esteem, although it is unclear whether that will indeed occur. Individuals with exceptionally low self-esteem and low life satisfaction may, in fact, suffer from depression, meaning that cognitive therapy, as opposed to cosmetic surgery, would be more beneficial. Most plastic surgeons are acutely aware of patients whose hope for the effects of surgery is unrealistic and could, in time, lead both to litigation and increased depression.

The present study particularly examined media exposure/consumption and attitudes toward cosmetic surgery. The significant effect of media exposure is inconsistent with the study by Brown et al ( 5 ), but is consistent with results from other studies ( 13 , 25 ). The current study showed that exposure to media was not related to the first factor (likelihood) but was related to the second factor (benefits) in the regressions. Those who consumed more media believed that cosmetic surgery brought more benefits

The present study also focused on religious beliefs and attitudes toward cosmetic surgery. More religious individuals may be likely to perceive cosmetic alteration as a direct contravention to their religious beliefs. Christian religious authorities strongly advocate the view that people should be less concerned with physical appearance (Philippians 2:3–4) and more concerned with religious issues (Proverbs 31:30) and that true beauty lies within an individual’s spirit (1 Peter 3:4) ( 28 ). Religiosity is a powerful determinant of an individual’s attitude toward several controversial topics ( 21 – 23 ) and therefore it is perhaps not surprising that it determines attitudes toward cosmetic surgery. Further research could explore whether this effect is found in all religions, because this study examined religiousness, not a particular religion per se. The role of religious beliefs and values on shaping attitudes to cosmetic surgery deserves greater research attention.

Acknowledgments

The authors are very grateful to Dr Viren Swami for his help and advice on all aspects of this article.

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Welcome 2024: Trends to Watch in Cosmetic Surgery

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The cosmetic and dermatologic surgery fields are continually evolving, with new trends emerging in response to changing societal norms, technological advancements, and patient preferences. Here are several notable trends in this field.

Popularity of Neuromodulators and Non-Invasive Treatments T

The COVID-19 pandemic fundamentally altered our work environments and personal perceptions. With the shift to remote work, individuals now spend more time on video calls, which increases their awareness of their physical appearance. This self-awareness has spurred a significant increase in the demand for cosmetic treatments like neuromodulators, dermal fillers, and other non-surgical procedures. These treatments, known for their convenience and minimal downtime, have become particularly appealing for those juggling work and personal life at home. Interestingly, this trend has remained strong even as people gradually return to office settings. The hybrid work model – a blend of office and remote work – continues to fuel the demand for these cosmetic enhancements.

Combining Surgeries With Less Invasive Methods

The cosmetic industry is observing a trend in which patients opt for a combination of surgical and non-surgical procedures to combat signs of aging. Initially, there was a significant lean towards non-invasive treatments like neuromodulators and fillers, which are less risky and require no downtime. However, as these methods primarily address surface-level concerns, there’s a renewed interest in surgical options for more comprehensive results. Surgical procedures, enhanced by technological advancements, are becoming more refined, increasing their appeal. These advancements include less invasive techniques, reduced recovery times, and more natural-looking results, making surgical options attractive for those seeking long-lasting solutions to aging-related changes.

Cosmetic Procedures Across All Ages

The demographic of those seeking aesthetic treatments has broadened significantly. Traditionally, cosmetic procedures were primarily sought by individuals in their 40s and older. However, there’s a noticeable trend of younger people, including those in their 20s, opting for aesthetic treatments. This shift can be attributed to the pervasive influence of social media platforms like Instagram and TikTok, which shape beauty standards and demystify cosmetic procedures. Additionally, the general acceptance of cosmetic enhancements has grown, eroding the stigma once associated with such treatments. This trend is further fueled by a better-informed public, who understand the options available and are keen to maintain their appearance, partly driven by the prevalence of video conferencing. Shift from

Seeking Perfection to Embracing Positivity

The cosmetic industry is witnessing a paradigm shift from pursuing an idealized notion of beauty towards a more inclusive and positive approach. This change in perspective challenges the traditional standards of beauty that often lead to unrealistic and artificial results. The current trend celebrates individual uniqueness and natural beauty. Influential brands and advertising campaigns are increasingly promoting diversity and individuality, encouraging people to embrace their natural looks rather than conform to a standardized ideal of beauty. This movement is not just a fleeting trend but represents a fundamental shift in societal attitudes toward beauty and self-acceptance.

Personalized Skincare Treatments for Every Skin Type

As the field of dermatology advances, there is a growing emphasis on customized skincare treatments. Recognizing that each skin type has its specific needs and challenges has led to the development of customized skincare regimens and treatments. This personalized approach ensures that individuals receive the most effective care for their skin type, whether addressing acne, hyperpigmentation, sensitivity, or aging concerns. For patients, this means actively engaging with their dermatologists and skin care professionals to ensure they receive treatments tailored to their unique dermatological needs.

Exploring the Skin’s Natural Healing Powers

Recent advancements in dermatology are increasingly focused on leveraging the body’s natural healing processes. Research into biologically active compounds like platelet-rich plasma (PRP) and lab-derived exosomes is at the forefront of this exploration. These innovative approaches aim to harness the body’s innate healing mechanisms to improve skin health and appearance. Applications of these technologies are diverse, ranging from rejuvenating aged skin to promoting hair growth and improving wound healing. This area of research holds significant promise, potentially revolutionizing how we approach skincare and cosmetic treatments by integrating the body’s biological processes.

Rising Interest in Body Contouring

In the post-pandemic era, there’s been a noticeable increase in interest in body contouring procedures. These treatments, which include liposuction, skin tightening, and other body sculpting techniques, are sought after by individuals looking to refine their body shape. The trend now is moving towards more personalized and targeted treatments. Rather than a one-size-fits-all approach, there is a growing demand for procedures focusing on specific body areas, such as the arms, thighs, or abdomen. This shift indicates a broader trend towards customized cosmetic treatments, reflecting individuals’ unique body-shaping goals and preferences.

In conclusion, cosmetic and dermatologic surgery continuously evolves, shaped by societal changes, technological advancements, and a deeper understanding of patients’ needs and desires. These trends highlight a shift toward more personalized treatments.

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The Impact of Cosmetic Plastic Surgery on Body Image and Psychological Well-Being: A Preliminary Study

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Genital Cosmetic Surgery in Women of Different Generations: A Qualitative Study

• Original Article
• Genital and Transgender Surgery
• Published: 15 August 2024

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• Bilge Nur Yıldırım Bayraktar   ORCID: orcid.org/0000-0002-4715-0458 1 ,
• Güleser Ada   ORCID: orcid.org/0000-0002-6300-6456 1 ,
• Yasemin Hamlacı Başkaya   ORCID: orcid.org/0000-0002-1533-8667 2 &
• Kevser Ilçioğlu   ORCID: orcid.org/0000-0002-4900-9095 3  

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Individuals from different generations are interacting more and more today, and while each generation exists with its own characteristics, this situation causes intergenerational differences in every issue in social life. Considering the characteristics of different generations, it is predicted that individuals’ views on genital cosmetic surgery may differ.

This study was conducted to examine the views of women of different generations on genital cosmetic surgery and to determine their perspectives on genital cosmetic surgery.

The population of the study consists of women from different generations. The sample of the study was formed using typical case sampling from purposive sampling methods. Data saturation was reached by conducting qualitative interviews with 15 women by selecting the snowball sampling method. Data were collected using a semi-structured individual interview form, and data analysis was performed using MAXQDA 2020.

The opinions of women of different generations about genital cosmetic surgery were analysed under four themes and 13 categories as “Perception of Beauty”, “Perception of Health”, “Perception of Society” and “Perception of Need”. The opinions of women of different generations about genital cosmetic surgery differ. It is thought that these differences may be caused by factors such as psychosocial, economic, environment, media, technological developments and culture.

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Bilge Nur Yıldırım Bayraktar & Güleser Ada

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [Bilge Nur Yildirim Bayraktar], [Güleser Ada], [Yasemin Hamlaci Başkaya] and [Kevser İlçioğlu]. The first draft of the manuscript was written by [Bilge Nur Yildirim Bayraktar], and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Yıldırım Bayraktar, B.N., Ada, G., Hamlacı Başkaya, Y. et al. Genital Cosmetic Surgery in Women of Different Generations: A Qualitative Study. Aesth Plast Surg (2024). https://doi.org/10.1007/s00266-024-04290-w

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Plastic & Reconstructive Surgery

Dr. dung nguyen and team receive r01 grant.

August 15, 2024

Dr. Dung Nguyen, a clinical professor in the Division of Plastic and Reconstructive Surgery, has received an R01 grant in the amount of $2.7M from the National Institutes of Health for her research project, “Development of a Bioengineered Therapeutic Device for the Prevention of Lymphedema.” 

“Lymphedema affects approximately 200 million patients globally, including 10 million in the US, often resulting from cancer treatments, especially in survivors of breast and gynecological cancers,” said Nguyen. “The condition leads to the accumulation of lymph fluid due to obstructions in the lymphatic vessels, compromising local immune function and causing irreversible structural changes in the affected tissues.” 

The funding will allow the team to create and refine specialized materials that closely resemble the structure of natural blood and lymphatic vessels. 

“This project proposes the use of nanofibrillar collagen conduits to bridge regions of lymphatic obstruction, promoting capillary flow and lymphatic regeneration. These studies aim to develop a novel biomaterials-based therapeutic strategy, with findings that could significantly impact the care of cancer patients who develop lymphedema,” said Nguyen.

These materials will be designed to support the growth of healthy cells and promote the repair of damaged lymphatic tissues. The team will also test these materials in animal models to evaluate their effectiveness in preventing and treating lymphedema.

The team conducting the research includes Dr. Ngan Huang, an associate professor in the Department of Cardiothoracic Surgery, and her lab at the Veterans Affairs Palo Alto Health Care System, and the Fibralign Corporation. 

Nguyen will lead the study at the Stanford University site including induction of lymphedema in a rat model, transfer of autologous lymph node tissue, and implantation of aligned nanofibrillar scaffolds. She will also provide instructional consultation to other study members to share her clinical experience regarding the use of the aligned nanofibrillar conduit.

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• U.S. Public Wary of Biomedical Technologies to ‘Enhance’ Human Abilities
• 5. From plastic surgery to vasectomies: Public opinion on current human enhancement options

Table of Contents

• 1. Understanding patterns in Americans’ reactions to gene editing, brain chip implants and synthetic blood transfusions that push boundaries of the human condition
• 2. U.S. public opinion on the future use of gene editing
• 3. Public opinion on the future use of brain implants
• 4. The public’s views on the future use of synthetic blood substitutes
• 6. Public sees science and technology as net positives for society
• Acknowledgments
• Methodology

While some types of potential human enhancements may seem like science fiction to observers not immersed in the world of biotechnology, there are any number of enhancements already available to the general public today. From laser eye surgery to teeth whitening, modern human enhancements are widely known today.

The theme of “everyday enhancements” arose first in the series of focus group discussions Pew Research Center held as part of the development of this survey. As people thought through the possibility of using cutting-edge enhancements such as gene editing, brain chip implants or synthetic blood in the future, many also drew connections to cosmetic surgery and other kinds of enhancements widely available today.

As a point of comparison, the survey also included a series of questions about the kinds of procedures people can undergo today. 13

The survey finds most Americans express a “go slower” reaction to the kinds of enhancements widely available today, mirroring some of the concerns expressed about future possibilities. But at least half of Americans – and in some cases, large majorities – say each of six kinds of enhancement procedures (ranging from surgery to prevent conception to eye surgery to elective cosmetic surgery) is an appropriate use of technology.

As with future possibilities for human enhancement, public views about cosmetic and other enhancements widely available today are tied to religious commitment. However, the magnitude of differences by religious commitment and religious affiliation on these types of procedures is relatively modest, by comparison with views about potential enhancements available in the future.

Most Americans say people are too quick to use cosmetic procedures today

Respondents were asked which statement is closer to their view: that “people are too quick to undergo cosmetic procedures in order to change their appearance in ways that are not really important,” or that “it’s understandable that more people undergo cosmetic procedures these days because it’s a competitive world and people who look more attractive tend to have an advantage.” Most U.S. adults (61%) choose the first, more negative statement, while 36% say cosmetic procedures are understandable.

There are modest differences in views about the use of cosmetic procedures by religious commitment. This pattern aligns with the much stronger differences by religious commitment about potential use of cutting-edge technologies considered in earlier chapters of this report. Some 65% of those in the “high” religious commitment category say “people are too quick to undergo cosmetic procedures,” compared with 56% of those with a low level of religious commitment.

There are only small differences across religious tradition on this question. Large shares of all major religious groups, including those with no religious affiliation, say people are too quick to undergo cosmetic procedures in ways that are not really important.

Many people have at least indirect experience with enhancement procedures

To gauge familiarity with enhancements available today, the survey asked respondents whether they ever had any of several kinds of procedures, including elective cosmetic surgery, laser eye surgery, skin or lip injections, cosmetic dental procedures, hair replacement surgery or vasectomy/tubal ligation procedures. Altogether, about three-in-ten Americans (31%) have had at least one of these six procedures, and most adults (58%) know a close friend or family member who has had one or more.

Most of these procedures are cosmetic in nature, while two are not: contraceptive surgery and laser eye surgery.

Tubal ligation and vasectomy are akin to some of the potential future enhancements in that they involve a surgical procedure with a specific aim – in this case, contraception. A third of adults have a close friend or family member who has had this surgery, while 15% of adults say they have had either a vasectomy or tubal ligation procedure themselves.

Laser eye surgery, another procedure typically classified as an elective, cosmetic procedure, is included in this context because it is a bodily change aimed at enhancing one’s natural vision. Some 9% of adults report having had laser eye surgery themselves, while 32% have a close friend or family member who has done so.

About one-in-ten Americans (11%) also report having had cosmetic dental procedures to improve their smile, while smaller shares say they have had elective cosmetic surgery (4%), skin or lip injections (2%) or hair replacement surgery (1%).

As one might expect, direct experience with these procedures tends to vary by gender, income and age. Some 38% of women and 24% of men say they have had one or more of the six procedures. Four-in-ten (39%) of those with family incomes of $150,000 or higher have had at least one of these procedures, compared with 26% among those with family incomes under $30,000 annually. Personal experience with the six procedures also is more common among older adults; 40% of those ages 65 and older have had at least one of the procedures, compared with 19% among adults ages 18 to 29.

For the most part, Americans say each of these six procedures is an appropriate use of technology. Some 89% say laser eye surgery is an appropriate use of technology, while just 8% say this is taking technology too far. A similarly large majority (86%) say cosmetic dental procedures to improve one’s smile are an appropriate use of technology, while 76% say the same about both hair replacement surgery and vasectomy or tubal ligation surgery.

A smaller majority (62%) says elective cosmetic surgery is an appropriate use of technology, and a slim majority (53%) says this about the use of skin and lip fillers (such as Botox or hyaluronic acid).

Differences by education and income are apparent in people’s views about the enhancements available today, particularly between those at the lowest levels of income and education compared with those in the middle and higher levels.

People with incomes of $75,000 or higher are particularly likely to say each of these six types of enhancements is an appropriate use of technology. 14  For instance, 78% of Americans in this income bracket say elective cosmetic surgery is an appropriate use of technology, compared with just half (49%) of those with family incomes under $30,000 – a gap of 29 percentage points.

Differences by educational attainment follow a similar pattern. For example, those with a college or postgraduate degree are more likely than adults with a high school degree or less schooling to say surgery to prevent pregnancy is an appropriate use of technology (86% vs. 65%).

Most Americans say cosmetic surgery is appropriate, but few see it as having more benefits than downsides for society

In focus group discussions with people around the country, some respondents talked about the similarity between the kinds of enhancements that may be available in the future and cosmetic surgery that is common now. Some focus group participants argued that both future human enhancements and cosmetic surgery were unnecessary and reflective of human vanity.

When asked specifically about cosmetic surgery, a majority of Americans (62%) say it is an appropriate use of technology, while about a third (34%) say it takes technology too far. There are sizeable differences on this question depending on personal experiences. An overwhelming majority of those who have had cosmetic surgery themselves (85%) say it is an appropriate use of technology. By contrast, 58% of those who have not had such a procedure and who do not have close friends or family who have had one say it is an appropriate use of technology, while 39% of this group says this is taking technology too far.

Those with lower levels of religious commitment are most inclined to say cosmetic surgery is an appropriate use of technology (73%). Among those who are highly religious, 55% say cosmetic surgery is appropriate and 39% say it takes technology too far.

Majorities of most major religious groups say cosmetic surgery is an appropriate use of technology. Black Protestants and Hispanic Catholics are more closely divided on this issue, as are blacks and Hispanics overall.

The general public appears somewhat skeptical about the psychological benefits of cosmetic surgery. About a quarter of Americans (26%) say cosmetic surgery “almost always” makes people feel more confident and better about themselves, but a majority (56%) say this only occurs “some of the time.”

About half of those who have had elective cosmetic surgery (53%) say it almost always makes people feel more confident and better about themselves. Fewer among those without such personal experience say the same, including 35% of those who have close friends or family who have had elective cosmetic surgery and 23% of those with neither type of personal connection to a cosmetic procedure.

On the other hand, just 8% of U.S. adults say cosmetic surgery “almost always” leads to unexpected health problems. Most (63%) say this sometimes occurs. Those who have had elective cosmetic surgery are less likely than others to say unexpected health problems occur at least some of the time.

Overall, about half of Americans (54%) say elective cosmetic surgery leads to both benefits and downsides for society, with a smaller share (26%) expressing the belief that there are more downsides than benefits. Relatively few (16%) say there are more benefits than downsides.

Again, those who have had elective cosmetic surgery are more likely to express positive views about it. 39% of people in this group say cosmetic surgery has more benefits than downsides for society, while just 12% say it has more downsides. But like the general population, about half (49%) say the benefits and downsides for society are roughly equal.

Religious commitment and affiliation do not have a significant effect on views of overall benefits and downsides of cosmetic surgery for society.

• These questions were asked in a survey conducted about a month later than the main survey covering gene editing, implanted devices and synthetic blood substitutes. See Methodology for details. ↩
• For an update on upper, middle and higher income levels in the U.S. see Pew Research Center’s May 2016 report, “ America’s Shrinking Middle Class: A Close Look at Changes Within Metropolitan Areas .” ↩

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85 Plastic Surgery Essay Topic Ideas & Examples

🏆 best plastic surgery topic ideas & essay examples, 📃 simple & easy plastic surgery essay titles, ✅ good essay topics on plastic surgery, ❓ research questions about plastic surgery.

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Perception of cosmetic surgery and associated side effects

A content analysis study of south korean female college students.

Editor(s): Chen., Robert J.

a College of Nursing, Chonnam National University, Gwangju, Republic of Korea

b College of Nursing, Jeju National University, Jeju-do, Republic of Korea.

∗Correspondence: Young A. Kim, College of Nursing, Jeju National University, 102 Jejudaehakno, Jeju-si, Jeju-do 63243, Republic of Korea (e-mail: [email protected] ).

How to cite this article: Chung HI, Kim YA. Perception of cosmetic surgery and associated side effects: a content analysis study of South Korean female college students. Medicine . 2022;101:3(e28641).

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT; Ministry of Science and ICT) (no. NRF-2017R1C1B5016043) and the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (no. NRF-2020R1I1A3065986).

The authors have no conflicts of interest to disclose.

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

This study explores the perception of female college students in South Korea regarding cosmetic surgery and its side effects.

Face-to-face interviews were conducted with 28 female college students over a period of 4 months, starting in October 2019. All participants were female college students who had not undergone cosmetic surgery. The collected data were analyzed qualitatively, using conventional content analysis.

Four categories and 13 subcategories were extracted from 112 meaningful codes reflecting perceptions related to cosmetic surgery and its associated side effects. The 4 categories that emerged in the study were: “reaction to the side effects of cosmetic surgery”, “reasons for cosmetic surgery”, “prospects of the participant's own cosmetic surgery”, and “prerequisites for decision-making regarding cosmetic surgery”.

The results of this study could be used as reference material by surgeons to ensure safer cosmetic surgeries. A sufficient consideration period and patient education prior to selective cosmetic surgery would minimize patient complaints and expand the base of safe cosmetic surgery.

1 Introduction

Advances in medical and technological innovations have led to the availability of numerous medical services, including a variety of cosmetic surgeries that are gaining popularity, from minimal and noninvasive procedures to major plastic surgeries. [1–3] Facial cosmetic surgery is extremely popular among South Korean adults in their 20s and 30s, with women accounting for an overwhelmingly larger proportion than men. [4,5]

With the popularity of cosmetic surgery, side effects such as failure of surgery, unexpected infections, and safety accidents are increasingly common, and these can have physical, psychological, and social consequences. [6–9] The Ministry of Health and Welfare of Korea reported that 52.5% of female college students underwent cosmetic surgery, and 12% experienced side effects. [10] Additionally, the gradual decrease in the age at which cosmetic surgery is attempted in South Korea has also led to concerns regarding side effects. [11]

However, despite the side effects, female college students in South Korea have had or intend to have cosmetic surgery, “to gain confidence”, “to become beautiful”, or “to get a job”. [10,12] They seem to believe that the benefits of cosmetic surgery outweigh the risk of side effects. In general, personal perception is an important factor that determines health-related behaviors. [13] Risk perception is often a factor that is considered while implementing and planning health behavior change interventions, and risk perception interventions can have an impact on subsequent health related behaviors. [14] However, the channels of information regarding the side effects of cosmetic surgery that affect the perception of female college students in South Korea tend not to involve communication by medical professionals, but rather the Internet and television. [15] Lack of high-quality information regarding the side effects and surgical complications associated with cosmetic surgery is not only a problem observed in South Korea but also in the United States. [9,16] Therefore, specific and detailed information regarding the perception of female college students in South Korea about cosmetic surgery and the associated side effects is needed to help understand the extent to which they are well or poorly informed and to devise strategies to influence appropriate health-related behavior in relation to cosmetic surgery.

To obtain such specific and detailed information, a qualitative study that explores the subjective opinions of research participants in a broad and inductive manner is likely to be more valuable than a quantitative study that focuses more on the relationship between specific hypothetical variables. [17] Therefore, this study aimed to qualitatively explore the perception of cosmetic surgery and its associated side effects in female college students in South Korea using content analysis.

This qualitative study was conducted from October 2019 to January 2020 to investigate the perception of cosmetic surgery and associated side effects in female college students in South Korea through in-depth interviews. The categories and subcategories were identified through content analysis.

2.1 Participants

The participants in this study were female college students who had not undergone cosmetic surgery. They were recruited through snowball sampling. Those students who gave their written informed consent to participate after being provided with information concerning the objective and intention of the study were selected as participants and were asked to realistically discuss their perception of cosmetic surgery and the associated side effects. The participants could withdraw their consent at any time after the study began, and students who did not agree to participate were excluded from the study. A total of 28 participants were interviewed 1 to 3 times each, and the average time required for the interviews was 29 minutes per person. Each participant was given a gift card worth $20 for the initial face-to-face interview, and any additional interviews were conducted telephonically.

2.2 Data collection

The data for this study were collected through in-depth face-to-face interviews in quiet offices and coffee shops. All interviews were recorded and transcribed with the permission of the participants. The first semi-structured question used in the interview was, “If you know any side effects of cosmetic surgery, please feel free to tell me what comes to mind”. During the interviews, questions such as, “What are the side effects of cosmetic surgery?” or “Why do people choose to have cosmetic surgery despite the side effects?” were asked to help the participants express their perception of cosmetic surgery and the associated side effects. Additionally, during the interview, the researchers used therapeutic communication skills such as clarification, reflection, and empathy to help participants focus on the subject of the study and comfortably engage in the interview. Data about the general characteristics of the participants were collected at the end of the interviews.

2.3 Data analysis

Data analysis was conducted using the conventional content analysis method introduced by Hsieh and Shannon. [18] To begin, the researchers sought to understand the overall meaning of the responses by carefully reading all the transcribed data repeatedly without predetermining categories. Subsequently, while reading the data which were transcribed verbatim, the researchers selected and coded the words, sentences, and paragraphs that contained important thoughts or concepts. The researchers noted first impressions, thoughts, and initial analysis, and then read the texts again together, to help determine relevant codes after several reflective processes. Related codes were collected and classified into sub-categories, and finally, the categories were identified. The degree of concordance between researchers was reconfirmed through the process of deciding whether to continue data collection through conversation, extracting concepts, and naming categories. To maintain research consistency and data analysis neutrality, a research note was kept, and regular researcher meetings were held.

2.4 Ethical considerations

This study was approved by the Institutional Review Board of Jeju National University (JJNU-IRB-2019-032). In addition, all procedures were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments. The students provided written informed consent to participate in the study.

The age of the study participants ranged from 19 to 22 years (average: 20.4). Specifically, 8 students were in their first year of university, 7 students in their second year, 8 students in their third year, and 5 students in their fourth year. All the participants knew about cosmetic surgery and the side effects associated with the procedures. Of the 28 participants, 12 stated that they would like to undergo cosmetic surgery or procedures in the future. A total of 112 meaningful codes reflecting their perception regarding cosmetic surgery and the associated side effects, and 4 categories and 13 subcategories were identified from the codes. The 4 categories identified in the study included, “reaction to the side effects of cosmetic surgery”, “reasons for cosmetic surgery”, “prospect of the participant's own cosmetic surgery”, and “prerequisites for decision-making regarding cosmetic surgery”.

3.1 Reaction to the side effects of cosmetic surgery

3.1.1 awareness.

“A lot of people undergo cosmetic surgery these days, and people do not seem to be aware about the side effects. However, I believe information about the adverse effects will make people reconsider their decision or decide not to undergo the surgery.” (Participant 1).

“The media has warned about the numerous adverse effects but people do not seem to be aware of them.” (Participant 15).

“We do not know what kind of side effects we will experience. It may seem fine now, but we do not know how things will shape up.” (Participant 2).

“I think the fear of side effects would discourage me.” (Participant 22).

3.1.3 Denial

“I think people undergo the procedures assuming that they would not experience any side effects. The chances of serious side effects are not so high anyway.” (Participant 6).

“I have heard of the possible side effects, but people still undergo cosmetic surgery. This makes me believe that I will not experience any side effects…” (Participant 18).

3.1.4 Minimal influence due to a desperate desire for change

“I think people who are really desperate will undergo surgery even though they know about the side effects. Those around me, who really wanted to do it, went for it. They even slept while sitting to reduce the swelling after blepharoplasty. They were really determined.” (Participant 4).

“Hope for improvement: Those who undergo cosmetic surgery despite knowing the side effects must be really desperate for it.” (Participant 15).

3.2 Reasons for cosmetic surgery

3.2.1 improvement in appearance.

“It helps them overcome complexes and become more confident in front of other people. They gain more confidence.” (Participant 8).

“Would it not make them feel more comfortable in front of other people when they are more beautiful and confident? Confidence will make them more outgoing and help them to form better relationships with others.” (Participant 28).

3.2.2 Self-satisfaction

“People may not be satisfied with how their face or body looks when it does not meet their own standards of beauty. Cosmetic surgery may get rid of your personal charm, but this charm does not matter if a person is not satisfied with themself.” (Participant 2).

“For self-satisfaction: Thinking, ‘this procedure will make me prettier’ and ‘just a small fix here will help’.” (Participant 3).

3.2.3 Response to lookism

“People are concerned about their appearance. Even elementary school students have begun to wear makeup. There is a general perception in society that ‘appearance matters’.” (Participant 3).

“I have heard that women with low self-confidence have cosmetic surgery more frequently to keep up with the appearance-oriented society in South Korea. While the perceptions of the people or society remain the same, I think women will undergo plastic surgery despite the side effects to keep up with the standards of beauty.” (Participant 24).

3.3 Prospect of the participant undergoing cosmetic surgery

3.3.1 willing to undergo surgery.

“I may want a face-lift when my face starts sagging as I get older.” (Participant 1).

“I would consider it when I get a lot of wrinkles in future.” (Participant 10).

3.3.2 Not willing to undergo surgery

“I can improve my expression and the shape of my face on my own. I have never considered cosmetic surgery. I intend to live the way I was born.” (Participant 18).

“The stakes to undergo cosmetic surgery seem to be too high for the pursuit of beauty. I may not go for it.” (Participant 11).

3.4 Prerequisites for decision-making regarding cosmetic surgery

3.4.1 many consultations.

“I think one should visit at least three hospitals. It would be important to visit many places for comparison.” (Participant 3).

“I think they should compare at least five hospitals and seek advice from people around them.” (Participant 10).

3.4.2 Consideration period

“I would not stop my friends from having cosmetic surgery, if they really want it. However, I will still recommend that they should think twice about it.” (Participant 8).

“I think it requires a lot of thought, but many people seem to just jump in.” (Participant 15).

3.4.3 Sufficient information

“Once you have decided to have cosmetic surgery, you need to do your research about the side effects.” (Participant 4).

“If you want to have cosmetic surgery, you need to know more about it. People only see the bright side. You really need to know everything, including the negative side.” (Participant 8).

3.4.4 Healthy self-love

“You could try to find your own charm in your natural face instead of making artificial improvements by cosmetic surgery. There is no way of reversing cosmetic surgery. You should be careful’.” (Participant 18).

“You really should try to be confident about your body and face no matter how you look or what your body type is, appreciating the good things that you have. You should take care of what is inside before working on the outside.” (Participant 25).

4 Discussion

Female college students in South Korea were found to be aware of the side effects of cosmetic surgery and had various related concerns, which accords with similar studies on other population groups. [19,20] Nevertheless, almost half of the study participants considered that people were drawn to consider undergoing cosmetic surgery for various reasons including a desperate desire for a change in their appearance after cosmetic surgery, belief that there would be no negative side effects, self-satisfaction, and in response to the expectations of society. Regarding the decision-making process for cosmetic surgery, the participants recommended that those considering cosmetic surgery should have the option of several consultations, a reasonable consideration period, and sufficient information be provided, while a healthy self-love should be encouraged in the meantime. Cosmetic surgery practitioners could focus on these factors when seeking to alleviate the side effects of cosmetic surgery.

Side effects and complications arising due to cosmetic surgery are common and have been repeatedly reported in recent studies. [16] The results of this study show that, to reduce unnecessary alarm and fear of the side effects associated with cosmetic surgery, relevant information must be provided through appropriately informed channels and methods involving professionals in the field. Studies have shown that many people intending to undergo cosmetic surgery use online platforms to gather and share advice. [3,21] Many cosmetic surgery experiences are posted on online platforms, including social networking services; the participants of this study also expressed their familiarity with information regarding cosmetic surgery on these platforms. Taking this into consideration, more medical professionals should be involved in providing information. This could lead to a positive change in otherwise negative reactions identified in the “reaction to the side effects of cosmetic surgery” category.

The quality and quantity of information, as well as communication with a medical professional, influence the perception of medical treatment, and the community and family play an important role in decision-making. [22,23] Losing patient confidence is a potential risk in the field of cosmetic surgery. [24] While people may seek to identify who can be trusted for such surgery, they may be confused due to the extensive marketing used. In response, practitioners of cosmetic surgery are recommended to consider conducting evidence-based promotion and counseling activities online. [21,25]

Estheticians need to be open to varying views concerning beauty, culture, or the social environment held by their patients and listen to their patients’ viewpoints sympathetically. [26] Additionally, adequate patient education is required prior to cosmetic surgery, and there is a need to openly discuss the number of treatments and the time (weeks to months) required to achieve the desired results. [3] Providing sufficient information to patients is also a major determinant of treatment satisfaction. [23] In this study, participants also recommended careful decision-making for cosmetic surgery, after a sufficient consideration period and adequate consultation with a medical institution. Provision of sufficient education before selective cosmetic surgery contributes to minimizing patient complaints.

Terms identified regarding how interactions with plastic surgeons could be improved have included, “informing”, “listening”, “acknowledging”, “clarifying”, and “moving forward”. [24] However, approaches sensitive to these identified terms have not always been applied in the field of plastic surgery, despite this being a field where subjective results are often more important than traditional indicators of outcome. The qualitative methodology used in this study facilitates the exploration of more complex issues that can arise in such fields, such as why patients choose to undergo plastic surgery, which has been explored in previous research, [17] and can provide an understanding of previously unrecognized social phenomena. [24]

While not seeking to generalize the experiences of women, qualitative research can be used to add depth to quantitative research in specific areas affecting women, which this study sought to do. The limitations of this study include its small sample size that the participants only comprised female college students in South Korea, and that only female college students who had not experienced cosmetic surgery were targeted. However, this study is significant as it showed that these participants were informed of the side effects of cosmetic surgery but that they expected that the surgery could be conducted safely.

5 Conclusions

The results of this study provide a more in-depth understanding of the perception of the side effects associated with cosmetic surgery in South Korean female college students. The insights from this study can be used to prepare educational material for medical service users to help them in careful decision-making and help guide the development of more effective health care policies. We recommend additional research to develop a questionnaire which can help subjects choose cosmetic surgery and prevent its side effects.

Acknowledgments

We would like to thank all participants who contributed to the production of this paper.

Author contributions

Conceptualization: Hyang-In Cho Chung, Young A Kim.

Data curation: Young A Kim.

Formal analysis: Hyang-In Cho Chung, Young A Kim.

Funding acquisition: Young A Kim.

Investigation: Young A Kim.

Methodology: Hyang-In Cho Chung, Young A Kim.

Supervision: Hyang-In Cho Chung.

Validation: Hyang-In Cho Chung, Young A Kim.

Writing – original draft: Young A Kim.

Writing – review & editing: Hyang-In Cho Chung, Young A Kim.

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perception; plastic surgery; qualitative research; side effects; women

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Bang si hyuk’s rumored lover “juicy seyeon” ridiculed for being unrecognizable in shocking alleged “before” plastic surgery photos.

Juicy Seyeon ‘s face before she allegedly got plastic surgery is going viral.

On August 13, a post titled “It’s So Funny How Juicy Seyeon Shuts Up When They Talk About Plastic Surgery LOL” went viral. The post has since been viewed almost 110K times.

In the post, the author writes how during an episode of Netflix’s The Influencer, Juicy Seyeon doesn’t say anything about the topic of cosmetic surgery, despite the fact the objective of the game was to score keywords.

She doesn’t open her mouth once because the topic is plastic surgery when she needs to bring keywords to stay in the game LOL. — Juicy Seyeon

The author then uploaded an alleged before photo of Juicy Seyeon. In the before photos, Bang Si Hyuk’s alleged lover looks strikingly different.

Netizens reacted to the post by flaming the influencer. Many were shocked to see that Juicy Seyeon looks unrecognizable in her past photo.

• “Juicy Seyeon and Beefy Si Hyuk.”
• “LOL, that was hilarious. She didn’t even know where to look, lol. The other women on the show were actively trying to win the game but Seyeon, who had her whole face constructed with aftermarket parts, wasn’t trying to say anything.”
• “(Her surgery results) Amazing.”
• “It’s so hilarious to see her not participating when she could’ve definitely won.”

• “Seeing that made me think she had low self-esteem. If she had been confident in herself, she would have participated like the other members, and people would’ve liked her more. I think she didn’t say anything because she was hurting.”
• “Ah, I’m embarrassed for her.”
• “Forget everything else, how did she fix the gap between her eyes? Someone tell me her doctor, please!”

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