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extreme) are justified. No. 20 | Apr. 10, 2017 Authors: Dr. Susan R. Madsen (Orin R. Woodbury Professor of Leadership & Ethics, Utah Valley University), Janika Dillon (Research Fellow, Utah Women & Leadership Project), and Robbyn T. Scribner (Research Fellow, Utah Women & Leadership Project). For questions or information: uwlp@usu.edu or www.utwomen.org Cosmetic Surgery Data According to the American Society for Aesthetic Plastic Surgery (ASAPS), in 2016, Americans spent a recordsetting 13.5 billion dollars on aesthetic procedures (surgical and nonsurgical combined). 19 Between the years of 2000 and 2015, the total number of cosmetic procedures performed in the United States increased by 115%. Although the rate of surgical procedures actually decreased slightly (by 10%) during those years, the large increase in procedures deemed “minimally invasive” was so high (158%) that it led to the overall dramatic increase in total procedures.20 A spokesperson for the industry explained some of this increase by stating that “youth is a commodity,” and that in a healthy economy, many people choose to “invest in themselves,” both personally and professionally, by electing to undergo such procedures.21 On a local level, Dr. Renato Saltz, a Salt Lake City plastic surgeon, said, “Utah is home to a sophisticated, well-educated population concerned about health and appearance, so it’s not surprising that Salt Lake has become a destination for patients who want safe, cutting-edge aesthetic surgery.” He also suggests that plastic surgery is a way to “reverse the wear and tear of pregnancy” on women’s bodies.22 With such attitudes pervading the national and local culture, it is not surprising so many women (who undergo 92% of all cosmetic procedures) 23 feel intense pressure and take significant steps to change their bodies. Utah has the nation’s sixth-highest number of plastic surgeons per capita. 24 Some suggest that many graduates of the University of Utah’s top-ranked plastic surgery residency program stay in Utah because of the market. 25 Statistics are collected by region, so there are no Utahspecific plastic surgery data. In fact, one recent survey that seems to contradict other studies and indicators found that Mormon women in Utah self-reported having cosmetic surgery at rates slightly lower than the national average.26 However, other data suggest cosmetic surgery is indeed a major consideration for many Utah women. For example, Utah is in the Mountain/Pacific region, which has the nation’s highest rates of cosmetic procedures, and the most popular procedure in the region is breast augmentation. 27 RealSelf.com reported that Utah topped its list on searches for breast augmentation (53% above the national average), 28 and the most common Google search for plastic surgery in Utah was “breast implants.”29 A qualitative research study on Mormon women in Utah showed that breast augmentations are sometimes given to young women at high school graduation. 30 National research shows that “Mommy Makeovers” (breast augmentation, tummy tuck, and liposuction) and other procedures are given to women as holiday presents.31 Cosmetic surgery can be expensive. Breast augmentation costs approximately $5,000–7,000, while Mommy Makeovers cost approximately $10,000–15,000.32 Some Utah doctors specialize in these procedures and offer financing to appeal to patients who might not otherwise be able to afford surgery. 33 Utah has also become a destination for out-of-state patients, perhaps because of lower prices and special accommodations such as post-operative nurses who care for patients in their hotel rooms.34 Cosmetic surgery is not without risks, and experts worry that some patients do not fully understand potential dangers. 35 Procedures are not permanent and sometimes fail. Doctors advertise repair procedures among their regular offerings. 36 There is even a reality television show, Botched, that highlights cases of plastic surgery gone wrong. 37 Moreover, psychologists have called for additional research to study some of the mental-health considerations (including depression, anxiety, body dysmorphic disorder and even suicide) linked to cosmetic surgery, both before and after procedures take place. 38 For example, several studies have shown that women who have had breast aug-mentation have higher rates of suicide, although a causal link has not been demonstrated. 39 Experts agree there is much about the connection between poor mental health and elective cosmetic surgery that is not well understood. Possible Contributing Factors Though it is difficult to pinpoint why cosmetic surgery levels are high in Utah, demographic information gives some clues. Researchers have found that homogenous societies, such as Utah, can have a contagion effect that pressures individuals into cosmetic surgery. 40 In Utah, 87.6% of the population identifies as white, 41 and Utah tops all the states in having the highest population of one religion: 57% are Mormon. 42 These factors may be linked to high plastic surgery rates. The American Society for Plastic Surgeons reports that 69% of people who undergo plastic surgery are white. 43 The Mormon Church strongly emphasizes marriage and motherhood, and Utah leads the nation in several categories relating
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