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      Demographic and Cultural Differences in the Acceptance and Pursuit of Cosmetic Surgery: A Systematic Literature Review

      research-article
      , MBBS 1 ,
      Plastic and Reconstructive Surgery Global Open
      Lippincott Williams & Wilkins

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          Background:

          Worldwide, the numbers of cosmetic procedures continue to climb. However, cosmetic surgery (CS) continues to be plagued by negative stigmatization. This study reviews the literature to identify how attitudes toward CS vary by sex, age, race, culture, and nationality, and aims to determine how other factors like media exposure interact with demographics to influence how well CS is accepted.

          Methods:

          A PRISMA-guided systematic review of the literature was conducted to identify all English-language papers reporting on CS or plastic surgery acceptance, attitudes, or stigmatization, specifically examining for data on age, sex, race/ethnicity, culture, and media influence.

          Results:

          In total, 1515 abstracts were reviewed, of which 94 were deemed pertinent enough to warrant a full-text review. Among the potential demographic predictors of CS acceptance, the one with the most supportive data is sex, with women comprising roughly 90% of all CS patients in virtually all populations studied and consistently exhibiting greater CS knowledge and acceptance. Culturally, the pursuit of beauty through CS is a universal phenomenon, although different countries, races, and cultures differ in how willingly CS is embraced, and in the aesthetic goals of those choosing to have it. In countries with culturally diverse societies like the United States, non-Hispanic Whites continue to predominate among CS patients, but the number of CS patients of other races is rising disproportionately. In this trend, social media is playing a major role.

          Conclusion:

          Healthcare practitioners performing cosmetic procedures need to consider demographic and cultural differences of the patients in order to enhance their understanding of their patients’ aesthetic goals and expectations.

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          Most cited references76

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          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.
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            Gender differences in body dysmorphic disorder.

            Gender differences in body dysmorphic disorder (BDD) have received little investigation. This study assessed gender differences in 188 subjects with BDD who were evaluated with instruments to assess demographic characteristics, clinical features of BDD, treatment history, and comorbid Axis I disorders. Ninety-three (49%) subjects were women, and 95 (51%) were men. Men and women did not significantly differ in terms of most variables examined, including rates of major depression, although women were more likely to be preoccupied with their hips and their weight, pick their skin and camouflage with makeup, and have comorbid bulimia nervosa. Men were more likely to be preoccupied with body build, genitals, and hair thinning, use a hat for camouflage, be unmarried, and have alcohol abuse or dependence. Although men were as likely as women to seek nonpsychiatric medical and surgical treatment, women were more likely to receive such care. Men, however, were as likely as women to have cosmetic surgery. Although the clinical features of BDD appear remarkably similar in women and men, there are some differences, some of which reflect those found in the general population, suggesting that cultural norms and values may influence the content of BDD symptoms.
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              Acceptance of cosmetic surgery: personality and individual difference predictors.

              This study examined the association between several attitudinal constructs related to acceptance of cosmetic surgery, and participant demographics, personality, and individual difference variables. A sample of 332 university students completed a battery of scales comprising the Acceptance of Cosmetic Surgery Scale (ACSS) and measures of the Big Five personality factors, self-esteem, conformity, self-assessed attractiveness, and demographics. Multiple regressions showed that the predictor variables explained a large proportion of the variance in ACSS factors (Adj. R(2) ranging between .31 and .60). In addition, structural equation modelling revealed that distal factors (sex and age) were generally associated with acceptance of cosmetic surgery through the mediate influence of more proximate variables (in the first instance, the Big Five personality factors, followed by self-esteem and conformity, and finally self-assessed attractiveness). These results allow for the presentation of a preliminary model integrating personality and individual differences in predicting acceptance of cosmetic surgery.
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                Author and article information

                Journal
                Plast Reconstr Surg Glob Open
                Plast Reconstr Surg Glob Open
                GOX
                Plastic and Reconstructive Surgery Global Open
                Lippincott Williams & Wilkins (Hagerstown, MD )
                2169-7574
                24 March 2021
                March 2021
                : 9
                : 3
                : e3501
                Affiliations
                [1]From the Plastic Surgery Section, Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
                Author notes
                Ahmed S. Alotaibi, MBBS, Plastic Surgery Section, Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, E-mail: Draotb@ 123456gmail.com
                Article
                00053
                10.1097/GOX.0000000000003501
                7990019
                33777604
                27f6d488-498e-4b9a-9faf-082348d005d5
                Copyright © 2021 The Author. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                : 29 January 2021
                : 29 January 2021
                Categories
                Cosmetic
                Original Article
                Custom metadata
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