Acceptance of cosmetic surgery: scale development and validation

We conducted a set of four studies with a total of 1288 adult and undergraduate women and men to develop the Acceptance of Cosmetic Surgery Scale. These studies provide evidence of this scale's reliability, as well as convergent and discriminant validity. Initial explorations using this 15-item scale indicate that acceptance of cosmetic surgery is negatively related to satisfaction with physical appearance and positively related to attitudes about make-up use. The acceptance of cosmetic surgery may be more related to fears about becoming unattractive than to hopes of becoming more attractive. Cosmetic surgery attitudes were positively related to age for women but not for men. The study's limitations and implications are discussed.     

Predicting interest in cosmetic surgery: Interactive effects of appearance-based rejection sensitivity and negative appearance comments

This study investigated effects of appearance-based rejection sensitivity (Appearance-RS) – the dispositional tendency to anxiously expect rejection based on one's appearance – in a sample of 133 American college students. Participants were randomly assigned to write an essay about either a negative or positive appearance comment they had received in the past. Compared to participants with lower Appearance-RS, those with higher Appearance-RS felt more rejected and expressed greater interest in cosmetic surgery after recalling a negative versus positive appearance comment. Content analysis of the essays revealed that negative appearance comments were most often made in reference to one's body weight/shape/size; positive appearance comments were most often made in reference to one's overall appearance. Peers/friends/romantic partners were the most frequently cited source of both positive and negative appearance comments. Overall, this research suggests that the interaction between the person and the situation is important to consider when predicting cosmetic surgery interest.     

Predicting interest in liposuction among women with eating problems: a population-based study

The purpose of this paper was to examine predictors of an interest in liposuction among women with eating problems. A questionnaire was sent to 3500 women aged 18-35 years, whereof 378 of 1861 responders screened positively on eating problems. Assessments included sociodemographic status, social network, physical exercise, attitudes towards cosmetic surgery, teasing history, body dysmorphic disorder-like symptoms, body image, self-esteem, personality, interpersonal attachment and emotional distress. Fifty-two percent reported an interest in liposuction, which was independently predicted by appearance orientation, appearance evaluation, being critical/quarrelsome, teasing history, wish for a better relationship with father, low education and being unmarried. Predictors differed somewhat from those previously found in the general population. Considering that our sample consisted of women with self-reported eating problems, the association between liposuction and eating behaviors should be further examined in a sample of patients with a formal eating disorder diagnosis.     

The factor structure and psychometric properties of the Italian version of the Acceptance of Cosmetic Surgery Scale

The current study examined the validity of the Italian version of the Acceptance of Cosmetic Surgery Scale (ACSS; Henderson-King & Henderson-King, 2005) in a sample of 378 Italian adult women. A series of confirmatory factor analyses were conducted. A three-factor solution provided the best fit to the data and confirmed the Intrapersonal, Social, and Consider dimensions. The three factors were strongly inter-correlated. Cronbach's alphas were high (all alphas > .86). The scale showed good convergent and discriminant validity (estimated by Composite Reliability and the Average Variance Extracted). The nomological validity of the Italian version of the ACSS was confirmed by its significant correlations with participants’ body dissatisfaction and sociocultural influences (internalization of thin ideals and perceived media pressure). The ACSS seems to be a useful measure of acceptance of cosmetic surgery in the Italian context. This instrument can be used with Italian speakers for research, health promotion, and preventive interventions.     

Body image and cosmetic medical treatments

Cosmetic medical treatments have become increasingly popular over the past decade. The explosion in popularity can be attributed to several factors—the evolution of safer, minimally invasive procedures, increased mass media attention, and the greater willingness of individuals to undergo cosmetic procedures as a means to enhance physical appearance. Medical and mental health professionals have long been interested in understanding both the motivations for seeking a change in physical appearance as well as the psychological outcomes of these treatments. Body image has been thought to play a key role in the decision to seek cosmetic procedures, however, only recently have studies investigated the pre- and postoperative body image concerns of patients. While body image dissatisfaction may motivate the pursuit of cosmetic medical treatments, psychiatric disorders characterized by body image disturbances, such as body dysmorphic disorder and eating disorders, may be relatively common among these patients. Subsequent research on persons who alter their physical appearance through cosmetic medical treatments are likely provide important information on the nature of body image.     

Blame it on patriarchy: More sexist attitudes are associated with stronger consideration of cosmetic surgery for oneself and one's partner

In the present work, we examined associations between oppressive, sexist beliefs and consideration of cosmetic surgery for oneself and also endorsement of cosmetic surgery for one's romantic partner. A total of 554 German‐speaking volunteers from the community, mainly in Austria, completed measures of consideration of cosmetic surgery and three measures of sexist attitudes, while a subset of participants in romantic relationships completed a measure of endorsement of cosmetic surgery for their partners along with the measures of sexism. Preliminary analyses showed that women and single respondents were more likely to consider having cosmetic surgery than men and committed respondents, respectively. Further analyses showed that consideration of cosmetic surgery for oneself was significantly associated with sexist attitudes, particularly hostile attitudes to women. In addition, among participants in a relationship, sexist attitudes were associated with endorsement of cosmetic surgery for one's partner. These results indicate that attitudes to cosmetic surgery for oneself and one's partner are shaped by gender‐ideological belief systems in patriarchal societies. Possible implications for understanding the motivations for having cosmetic surgery, among both single respondents and couples, are discussed.     

Body appreciation, media influence, and weight status predict consideration of cosmetic surgery among female undergraduates

The current study examined the association between consideration of cosmetic surgery, body appreciation, media influence, and participant demographics. In total, 322 female university students completed the Consider subscale of the Acceptance of Cosmetic Surgery Scale, the third revision of Sociocultural Attitudes Toward Appearance Scale (SATAQ-3), the Body Appreciation Scale (BAS), and provided their demographic details. Bivariate correlations showed that consideration of cosmetic surgery was significantly and positively correlated with three of the SATAQ-3 subscales and negatively correlated with BAS scores, age, and body mass index (BMI). A multiple regression showed that the only significant predictors of consideration of cosmetic surgery were greater media influence, less body appreciation, and lower BMI. These results are discussed in relation to the extant literature on attitudes towards cosmetic surgery.     

Cosmetic surgery and the relationship between appearance satisfaction and extraversion: Testing a transactional model of personality

Few studies have tested potential explanatory mechanisms for the high stability of extraversion. In this study, the relationship between extraversion, appearance evaluation, and cosmetic surgery was investigated to examine such mechanisms. The “Big Five” personality traits were assessed in 155 female cosmetic surgery patients prior to and 6 months after surgery, as well as from a representative sample of 907 women. Patients showed higher extraversion scores prior to surgery than were found in the representative sample; further, extraversion scores increased after surgery, while the increase diminished when controlled for appearance evaluation. The results are in accordance with a transactional model, whereby extraverts engage in actions that reinforce extravert tendencies, which may account for the high stability of extraversion.     

Body dysmorphic disorder and appearance enhancing medical treatments

This article reviews the literature on body dysmorphic disorder (BDD) in persons who seek appearance enhancing medical treatments such as cosmetic surgery and dermatological treatment. We begin with a discussion of the growing popularity of cosmetic surgical and minimally invasive treatments. The literature investigating the psychological characteristics is briefly highlighted. Studies investigating the rate of BDD among persons who seek appearance enhancing treatments are detailed and, collectively, suggest that approximately 5–15% of individuals who seek these treatments suffer from BDD. Retrospective reports suggest that persons with BDD rarely experience improvement in their symptoms following these treatments, leading some to suggest that BDD is a contraindication to cosmetic surgery and other treatments. The clinical management of patients with BDD who present for these treatments is briefly described and directions for future research are provided.     

Cosmetic surgery in inpatients with eating disorders: attitudes and experience

Body image disturbance is frequent among individuals undergoing cosmetic surgery and core to the pathology of eating disorders (ED); however, there is little research examining cosmetic surgery in ED. This study examined body image related measures, ED behaviors, and depression as predictors of attitudes toward cosmetic surgery in 129 women with ED. Patients who had undergone surgery (n = 16, 12%) were compared to those who had not. Having a purging diagnosis, linking success to appearance, and making physical appearance comparisons were predictive of more favorable cosmetic surgery attitudes. All of those who had undergone surgery had purging diagnoses and, on average, were older, had higher BMIs, and were more likely to make physical appearance comparisons and know someone who had undergone surgery. In ED, acceptance and pursuit of cosmetic surgery appears to be related to social group influences more than weight and shape disturbance, media influences, or mood.