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condition. This would suggest that exposure to cosmetic images makes participants particularly likely to desire cosmetic surgery when they use social media a lot. Discussion The current study aimed to explore whether exposure to images with facial cosmetic enhancements increases the desire for cosmetic surgery. Furthermore, we planned to test the mediation model that social media use leads to body dissatisfaction which in turn makes people desire cosmetic surgery. The results showed that viewing images of cosmetically enhanced females had a marginally significant effect on desire for cosmetic surgery. These results therefore partially supported the hypothesis that cosmetic enhancement images (compared to a control condition) induce a desire for cosmetic surgery. Moreover, those who were frequent social media users and who were less satisfied with their appearance were more likely to consider cosmetic surgery in the future. Although higher social media use did not lower appearance satisfaction per se, participants who saw cosmetically enhanced females (vs. travel images) and who used social media a lot were significantly more likely to desire cosmetic surgery. Lastly, the results show that the relationship between social media use and desire for cosmetic surgery was not mediated by body dissatisfaction. Social media use was a stronger predictor of a participants’ desire for cosmetic surgery than body dissatisfaction. These findings therefore suggest that viewing images of females with cosmetic enhancements can have an effect on young women’s desire for cosmetic surgery, especially if they frequently spend a significant amount of time on social media, follow many accounts and are less satisfied with their appearance. The present results are in line with previous research by showing that those who use social media more (De Vries et al. 2014) and are dissatisfied with their appearance (Lee et al. 2009; Markey and Markey 2009) are more likely to consider cosmetic surgery. However, it should be noted that the desire for cosmetic surgery between participants in the cosmetic enhancement and travel condition was only marginally significant. Psychological movements placing an emphasis on the acceptance of one’s body, such as body compassion (Altman et al. 2017a) and the acceptance and commitment approach (Hayes et al. 2012) have gained popularity as treatments for body image dissatisfaction (Hill et al. 2015; Altman et al. 2017b). These movements encourage one to shift their view of the body from one of judgement and comparison to societal ideals, to one of openness and curiosity, embracing the appearance, state of health, and functioning of one’s body exactly as it is in the present (Altman et al. 2017b). Similarly, in popular culture there has been a rise in movements placing an emphasis on self-love and acceptance, such as the ‘body positive movement’ and campaigns seeing popular high-street fashion brands no longer digitally retouching photos of their models (The Independent 2017; Tan 2018). Young women are being encouraged to embrace and accept the way that they look, and in turn, this could make them less likely to want to undergo cosmetic procedures to change the way they look. For example, the number of cosmetic procedures conducted in 2016 fell 40% from a record-breaking high in 2015 (British Association of Aesthetic Plastic Surgeons 2017). In this way, the decreased societal pressure to conform to an idealized beauty standard may be encouraging women away from having cosmetic surgery (Henderson-King and Brooks 2009). The present study tested a mediation model proposing that increased social media use leads to dissatisfaction with one’s appearance which in turn induces a desire for cosmetic surgery. Previous research has found that social network site use can impact desire for cosmetic surgery (De Vries et al. 2014), body dissatisfaction influences attitudes towards cosmetic Fig. 1 Mediation model for the effect of social media use on desire for cosmetic surgery via body dissatisfaction. Values for the indirect path (i.e., when controlling for the mediator) are shown in parenthesis Curr Psychol surgery (Lee et al. 2009; Markey and Markey 2009), and social media use negatively affects body satisfaction (Brown and Tiggemann 2016; Holland and Tiggemann 2016). In this study, the mediating role of body dissatisfaction was not supported. This may be because previous research was correlational, suggesting an increased likelihood that body dissatisfaction is influencing desire for cosmetic surgery but not a causational influence. Therefore, it could be the case that some other unknown factors are underlying this relationship. An alternative mediator may be appearance investment. De Vries et al. (2014) showed that among adolescents more frequent social network site use predicts increases in appearance investment, which is related to an increased desire to undergo cosmetic surgery. Similarly, Sarwer et al. (2005) found that greater psychological investment in physical appearance predicted more favourable attitudes towards cosmetic surgery. Thus, social media could be influencing desire for cosmetic surgery via appearance investment. As such, the appearance pressures exerted by social media may lead people who are more invested in their
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