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DOI 10.1007/s11199-010-9759-5 encounters (e.g., cat calls, checking out or gazing at women’s bodies, sexual comments, harassment) and exposure to visual media that “spotlights” women’s bodies and body parts. From this perspective, girls and women come to place excessive emphasis on physical appearance as a result of these sexual objectification practices, ultimately adopting an external observational standpoint on their bodies such that “they treat themselves as objects to be looked at and evaluated” (p. 177, emphasis in original). Adopting this particular vantage point on the self, referred to as self-objectification, requires women to chronically ‘police’ or self-monitor their bodies in anticipation of being evaluated based on their appearance. Typically referred to as self-surveillance (McKinley and Hyde 1996; Tiggemann and Slater 2001), this engagement in chronic body monitoring is a common behavioural manifestation of self-objectification. Given the myriad social and economic rewards women earn for their physical attractiveness (Dellinger and Williams 1997; Eagly et al. 1991), and in an effort to cope with incessant external pressures to meet beauty ideals (Calogero et al. 2007; Thompson et al. 1999), many women experience objectified relationships with their own bodies in the form of self-objectification and selfsurveillance. The intended focus of objectification theory was to explicate the consequences of sexual and self-objectification for women’s lived experiences. Empirical studies have demonstrated that both interpersonal forms (Hill and Fischer 2008; Kozee and Tylka 2006; Kozee et al. 2007; Moradi et al. 2005) and media forms (Harper and Tiggemann 2008; Morry and Staska 2001) of sexual objectification contribute to self-objectification. Moreover, there is strong evidence from studies of women across North America, Australia, and the U.K. indicating that self-objectification, and the concomitant self-surveillance, exact significant costs on women’s subjective well-being (Breines et al. 2008; Fairchild and Rudman 2008) and cognitive performance (Fredrickson et al. 1998; Quinn et al. 2006b), with a greater prevalence of selfharming behavior (Harrell et al. 2006; Muehlenkamp et al. 2005) and a disproportionately higher rate of mental health risks, including depression (Grabe et al. 2007; Tiggemann and Kuring 2004), disordered eating (Calogero et al. 2005; Tylka and Hill 2004), and sexual dysfunction (Calogero and Thompson 2009b; Steer and Tiggemann 2008). In particular, researchers have identified body shame—the degree to which women feel ashamed of their bodies when they perceive them as falling short of feminine beauty ideals (McKinley and Hyde 1996)—as a key negative emotional consequence of self-objectification (Fredrickson and Roberts 1997; Moradi and Huang 2008). Body shame consistently mediates the effects of selfobjectification on well-being and mental health (Noll and Fredrickson 1998; Quinn et al. 2006a; Tiggemann and Slater 2001), and thus is a critical variable in the objectification theory framework. In the present research, we submit that positive attitudes toward cosmetic surgery among women reflect another negative consequence stemming from the socio-cultural conditions that perpetuate the objectification of women’s bodies. Indeed, the tremendous increase in elective cosmetic procedures (surgical and minimally invasive) over the past decade or more is due primarily to the disproportionately higher number of female patients who sought these treatments. Between 1992 and 2008, total cosmetic procedures performed in the U.S. increased by 882%, with over $10 billion spent on these procedures in 2008 (American Society of Plastic Surgeons [ASPS] 2009). This extreme growth in cosmetic procedures is not limited to the U.S.: Between 2003 and 2008, the number of surgical procedures performed in the U.K. more than tripled (British Association of Aesthetic and Plastic Surgeons [BAAPS] 2009). In both of these westernized societies, 91% of these procedures are performed routinely on women, whereas 9% are performed on men (ASPS 2009). In addition to the significant depletion of women’s economic resources (Hesse-Biber et al. 2006; Tiggemann and Rothblum 1997), this high percentage of women undergoing cosmetic surgery is particularly troubling because of the numerous deleterious consequences associated with these procedures, which are well-known among cosmetic surgeons but virtually unknown among the general population, such as chronic pain, deadly infections, gangrene, nerve damage, loss of sensation, mutilated body parts, amputation, reoperation, cancer detection difficulty, suicide, and death (Haiken 1997; Jeffreys 2005; McLaughlin et al. 2004; Wolf 1991; Zones 2000). Researchers have linked a variety of interpersonal and intrapersonal variables to people’s attitudes toward cosmetic surgery (Sarwer et al. 1998, 2003b; Swami and Furnham 2008), such as negative body image (Brown et al. 2007; Markey and Markey 2009), appearance-based self-esteem (Delinsky 2005), attachment anxiety (Davis and Vernon 2002), Big-Five personality traits (Swami et al. 2009a), previous personal or vicarious experiences with cosmetic surgery (Swami et al. 2008), intense-personal celebrity worship (Swami et al. 2009b), materialism and parental attitudes (Henderson-King and Brooks
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