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Multivariate Logistic Regression Odds Ratio Confidence Interval P Odds Ratio Confidence Interval P Age January 2019, Volume 7, Number 1 traction and income level even by controlling variables such as age, the level of education, marital status, number of employment years and so on. The results of Babuccu, Latifoglu, Atabay, Oral and Cosan (2003) study indicate that rich people undergo the highest number of surgeries (with income higher than 8000000 IRR). In a study, it was found that one of the factors affecting cosmetic surgery was educational level rather than income, such that the educational level of applicants of cosmetic surgery was higher than the mean educational level of Iranian women and most of the applicants had university degrees (Mohammadpanah et al., 2012). The results of Mirsardoo, Kaldi and Ataee (2011) study reveal a significant relationship between variables of educational level, family income and cosmetic surgery orientation and also between variables of monthly income and cosmetic surgery or orientation surgery. However, the results of the present study indicate that the chance of being an applicant for cosmetic surgery in people with an income level of higher than 5000000 IRR is 13.93 times more than those with an income level of lower than 5000000 IRR. Why applicants of cosmetic surgery were students or those with university degrees? Possibly, that students want to be more beautiful than other people because of the sexual and environmental attractions at universities (Mohammadpanah et al., 2012). In the end, cosmetic surgery is a paradox that has been stuck between individual satisfaction and social norms as well as between the domination of capitalists and consumerism. On one hand, the role of social norms and pressures should be considered that would persuade individuals to such surgeries. On the other hand, concerning the position of women in society and the growth of individualism, cosmetic surgery serves a different goal. Undergoing such operations can be interpreted as resistance against social stereotypes and norms. The women undergo such surgeries for acquiring power because beauty is accompanied with power and allows women to use it in a society with unequal profit opportunities. Since the media should have a responsibility to encourage individuals toward a healthy lifestyle, it is suggested that cultural patterns and factors are introduced by multimedia as incentives for correct decision making and preventing blind imitation. This study had several limitations. First, the study data were collected from one geographical region. Second, we used convenience sampling method to collect the samples. Therefore, the results should be cautiously generalized to other geographical regions. Furthermore, the non-applicant participants were just relatives of the applicants, who simply mentioned their no intention of doing cosmetic surgery. However, they may have other plans that didn’t mention. According to the present results, although the mean scores of self-esteem, body image, and psychological problems were higher in non-applicants of cosmetic surgery, the differences were not statistically important. On the other hand, it seems that self-esteem, body image, and psychological problems are not the only factors which may peruse Iranians to undergo cosmetic surgery. Therefore, it is necessary to design longitudinal studies to assess the causal factors that may lead to choosing cosmetic surgery among the Iranian population with more details. Ethical Considerations Compliance with ethical guidelines Kerman University of Medical Sciences approved this project (Ethical code: 56/93/k). After the approval, necessary permissions were taken from the management of Ali-ebne-Abitaleb and Morady hospitals of Rafsanjan City. The researcher informed all participants about the study objectives, the confidentiality, and anonymity of the participants’ information, and their right to withdraw from the study at any time. All subjects gave their verbal consent. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors. Authors contributions All authors contributed in preparing this article. Conflict of interest The authors declare no conflict of interest. Acknowledgements The researchers would like to appreciate all the participants and the Research Council of the Kerman University of Medical Sciences who provided facilities for conducting this study. Body Dysmorphic Disorder and Cosmetic Surgery Canice E. Crerand, Ph.D. Martin E. Franklin, Ph.D. David B. Sarwer, Ph.D. Philadelphia, Pa. Learning Objectives: After studying this article, the participant should be able to: 1. Identify the diagnostic criteria and clinical features of body dysmorphic disorder. 2. Describe the prevalence of body dysmorphic disorder in cosmetic populations. 3. Identify appropriate treatment strategies for body dysmorphic disorder. Background: Body dysmorphic disorder is a relatively common psychiatric disorder among persons who seek cosmetic surgical and minimally invasive treatments. Methods: This article reviews the history of the diagnosis and the current diagnostic criteria. Etiologic theories, clinical and demographic characteristics, and comorbidity, including the relationship of body dysmorphic disorder to obsessive-compulsive spectrum and impulse control disorders,
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