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      Cosmetic Surgery and Self-esteem in South Korea: A Systematic Review and Meta-analysis


      1 , , 2

      Aesthetic Plastic Surgery

      Springer US

      Esthetic, Cosmetic, Plastic surgery, Attitude, Self-esteem

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          Advances in medical technology coupled with rapid growth of web-based mass media and social networking services have considerably increased public access to cosmetic surgery. In South Korea, in particular, the number of people undergoing cosmetic surgery has been rapidly increasing, and studies related to cosmetic surgery have markedly increased. We report an integrative review of studies examining the relationship between cosmetic surgery and self-esteem in Korea. We aimed to identify relevant variables and determine their overall effect sizes.


          This study was designed based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Two researchers separately performed the literature search, selected 16 papers based on the inclusion and exclusion criteria, and analyzed them.


          Of the 16 papers on cosmetic surgery and self-esteem, 5 (33.3%) involved both men and women, and the remaining 11 (66.7%) involved only women. The respondents included teenagers and adults. The total number of respondents was 6296, with an average of 393.5 per paper. Most studies ( n = 13, 81.3%) used the Rosenberg Self-Esteem Scale. Self-esteem was correlated with variables grouped into the following six categories: appearance management intention, cosmetic surgery intention, sociocultural attitude, body satisfaction, BMI, and stress. The effect sizes from the meta-analysis with correlation coefficients were 0.157, − 0.118, 0.023, 0.175, − 0.045, and − 0.085.


          Among the relevant variables categorized in this study, sociocultural attitude, BMI, and stress showed weak effect sizes, and the appearance management intention, cosmetic surgery intention, and body satisfaction categories showed intermediate effect sizes. The results of this study are expected to serve as a concrete basis for the development of strategies to minimize the adverse effects of the ever-growing cosmetic surgery industry. This information can help elucidate the psychologic characteristics of individuals seeking cosmetic surgery and contribute to optimal medical outcomes.

          Level of Evidence IV

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          Most cited references 39

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          A graphical method for exploring heterogeneity in meta-analyses: application to a meta-analysis of 65 trials.

          Heterogeneity can be a major component of meta-analyses and by virtue of that fact warrants investigation. Classic analysis methods, such as meta-regression, are used to explore the sources of heterogeneity. However, it may be difficult to apply such a method in complex cases or in the absence of an a priori hypothesis. This paper presents a graphical method to identify trials, groups of trials or groups of patients that are sources of heterogeneity. The contribution of these trials to the overall result can also be evaluated with this method. Each trial is represented by a dot on a 2D graph. The X-axis represents the contribution of the trial to the overall Cochran Q-test for heterogeneity. The Y-axis represents the influence of the trial, defined as the standardized squared difference between the treatment effects estimated with and without the trial. This approach has been applied to data from the Meta-Analysis of Chemotherapy in Head and Neck Cancer (MACH-NC) comprising 10,850 patients in 65 randomized trials. The graphical method allowed us to identify trials that contributed considerably to the overall heterogeneity and had a strong influence on the overall result. It also provided useful information for the interpretation of heterogeneity in this meta-analysis. The proposed graphical method identifies trials that account for most of the heterogeneity without having to explore all possible sources of heterogeneity by subgroup analyses. This method can also be applied to identify types of patients that explain heterogeneity in the treatment effect. Copyright 2002 John Wiley & Sons, Ltd.
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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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              Body Image and Self-Esteem Among Adolescent Girls: Testing the Influence of Sociocultural Factors


                Author and article information

                Aesthetic Plast Surg
                Aesthetic Plast Surg
                Aesthetic Plastic Surgery
                Springer US (New York )
                21 October 2019
                21 October 2019
                : 44
                : 1
                : 229-238
                [1 ]GRID grid.412077.7, ISNI 0000 0001 0744 1296, Division of Mathematics and Big Data Science, , Daegu University, ; Gyeongsan-si, Gyeongsanbuk-do Republic of Korea
                [2 ]GRID grid.411277.6, ISNI 0000 0001 0725 5207, College of Nursing, , Jeju National University, ; 102 Jejudaehakno, Jeju-si, Jeju-do 63243 Republic of Korea
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                Funded by: National Research Foundation of Korea (NRF) grant funded by the Korea government(MSIT; Ministry of Science and ICT)
                Award ID: NRF-2017R1C1B5016043
                Award Recipient :
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                © Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020


                esthetic, cosmetic, plastic surgery, attitude, self-esteem


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