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compared to their pre-surgery level.50 In addition, a very small qualitative study which included five men who had undergone cosmetic procedures (three non-invasive; two invasive) which concluded that all five reported that the procedure had improved their confidence, and that “the surgery affected how they were perceived and treated by others” (see sections below for further discussion on others’ reactions to results of cosmetic procedures as a contributing factor to satisfaction levels, and dissatisfaction levels).51 Among young people, confidence levels of those who have received a cosmetic procedure have also been shown to rise for some recipients: for example, a Turkish 47 Atkinson M (2008) Exploring male femininity in the ‘crisis’: men and cosmetic surgery Body & Society 14(1): 67-87. 48 Thorpe SJ, Ahmed B, and Steer K (2004) Reasons for undergoing cosmetic surgery: a retrospective study Sexualities, Evolution & Gender 6(2-3): 75-96. 49 Borelli F, and Casotti LM (2012) The before and after: a study of plastic surgery consumption with young women in Brazil Advances in Consumer Research 40: 379-85. 50 von Soest T, Kvalem IL, Skolleborg KC, and Roald HE (2011) Psychosocial changes after cosmetic surgery: a 5-year follow-up study Plastic and Reconstructive Surgery 128(3): 765-72. 51 Ricciardelli R, and White P (2011) Modifying the body: Canadian men’s perspectives on appearance and cosmetic surgery The Qualitative Report 16(4): 949-70. 13 study of 86 young people who had undergone a cosmetic procedure showed that 47/61 young females, and 17/25 young males indicated an increase in self-confidence.52 However, a community based sample study – a type of study rarely identified by this review – examined whether having cosmetic surgery would act as a protective factor in age-related experiences related to body image, self-esteem, and ageing attitudes. The length since surgery had been undertaken in this study ranged from one to 45 years. The researcher found that cosmetic procedure recipients indicated less body satisfaction with age, and that those who had not received cosmetic surgery showed increases in self-esteem with age. Further, the study also suggested that “nonrecipients [of cosmetic surgeries] reported a greater level of age discrepancy than did recipients – they reported feeling even younger than their actual chronological age compared to cosmetic surgery recipients. Thus, despite having undertaken action to improve their appearance through surgical means at some point in their adult lives, cosmetic surgery recipients do not inevitably feel younger than their years compared to those who, for whatever reason, have not pursued surgery.”53 Breast procedures Reduction “My life has changed: I became more confident; I was no longer embarrassed about getting close to men. I got a boyfriend right away. I became more popular among my friends. I think people saw how I was prettier, more secure. I was no longer embarrassed about going out... people would ask me out more, and I began socializing more, too. I started feeling more sociable than before.” 54 “I’m not so embarrassed or trying to hide all the time.” 55 Qualitative small-scale studies identified by this review suggest that self-esteem is a contributing factor for satisfaction following BR. For example, a US study involving a small sample of 13 patients who had undergone a cosmetic procedure examined how participants understood and measured the success of their cosmetic procedure. The authors found that success was measured by broad changes to their lives, rather than about a certain physical trait being ‘improved’ or ‘looking better’. They highlight, for example, the observations of one woman who had undergone a BR procedure: “It changed my life. Increased my confidence, self-esteem”. The same participant suggests 52 Kamburoğlu HO, and Özgür F (2007) Postoperative satisfaction and the patient’s body image, life satisfaction, and self-esteem: a retrospective study comparing adolescent girls and boys after cosmetic surgery Aesthetic Plastic Surgery 31(6): 739-45. 53 Eriksen SJ (2012) To cut or not to cut: cosmetic surgery usage and women's age-related experiences The International Journal of Aging and Human Development 74(1): 1-24. 54 31-year-old recipient of BR in Borelli F, and Casotti LM (2012) The before and after: a study of plastic surgery consumption with young women in Brazil Advances in Consumer Research 40: 379-85. 55 Klassen A, Pusic A, Scott A, Klok J, and Cano S (2009) Satisfaction and quality of life in women who undergo breast surgery: a qualitative study BMC Women’s Health 9(1): 11. 14 “maybe I was just freed. After the surgery I just felt beautiful.”56 Similarly, a qualitative study also from Canada observes that “changes in self-confidence appeared most dramatic among BR patients, who literally described walking taller post-surgery: “You don’t have this extra weight hanging there, so you hold your head up higher. You don’t feel like you’re all, all bosom. There is more to you than that now.”57 A further Canadian study involving 55 BR recipients also found that self-esteem had improved six-months following the procedure and remained stable at the 21.5-month assessment point.58 Augmentation Some BA recipients have also been found to undergo significant improvement in selfesteem and
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