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This study examined adolescent girls’ views of cosmetic surgery. Seven focus groups were run with girls aged 15 to 18 (N = 27). Participants read case studies of women having cosmetic surgery, followed by discussion and exploration of their views. Thematic analysis identified four themes: (1) Dissatisfaction with appearance, (2) Acceptability of cosmetic surgery, (3) Feelings about undergoing cosmetic surgery, and (4) Cosmetic surgery in the media. Results suggest the acceptability of cosmetic surgery varies according to the reasons for having it; and that the media plays an important role by normalising surgery and under-representing the risks associated with it. RUNNING HEAD: Adolescents’ views on cosmetic surgery 3 Introduction Cosmetic surgery (CS) has become relatively affordable, commonplace and more acceptable form of surgery (Frederick, Lever, & Peplau, 2007). CS differs from reconstructive surgery in that it is purely elective and does not involve congenital or other deformities; rather, it is aimed at improving features for purely aesthetic reasons. The American Society of Plastic Surgeons (ASPS 2000; 2010) reports that rates of CS are increasing and that adolescents are also undergoing such surgery. The number of CS procedures carried out in the United States (US) increased from 12.1 million in 2008 to 13.1 million in 2010, and adolescents typically account for 1.3 to 3.5% (125,397 – 298,704 adolescent patients) of procedures carried out each year (ASPS, 2010). The increased popularity of CS is due to a number of factors. Technological advances make procedures less invasive, financial plans and loans make CS more affordable. Increased media attention to CS is also likely to play a role in promoting and normalising CS (Tait, 2007). Cosmetic surgery is widely covered in the media, including advertising, celebrity news stories, magazine articles, and reality TV shows. Cosmetic surgery associations have expressed concerns that the nature of this coverage may trivialise and misrepresent the severity of CS. Specific concern has been expressed with regards to adolescents, a “young impressionable audience...already selfconscious about their body image” (ASPS, 2004), who “are being targeted heavily” (BBC News, 19 September, 2008). Risks of undergoing CS are substantial. The two most popular cosmetic procedures for adolescent girls are breast augmentation and liposuction (Zuckerman & Abraham, 2008). A review of these procedures shows risks associated with these procedures include normal risks of surgery, higher complication rates, financial, and health risks. All this may be amplified by the use of surgery at a time when girls’ bodies are still developing. Physical complications from surgery include pain, scarring, infection and postoperative bleeding. Long-term physical complications that can arise include loss of physical sensations, implant rupture (in the case of breast augmentation), RUNNING HEAD: Adolescents’ views on cosmetic surgery 4 and the need for additional surgery. With implants the risk increases over time, meaning adolescents may require repeated surgery in future years and suffer other complications. For example, breast implants interfere with the accuracy of mammographies, so cancer is less likely to be detected in these women (Zuckerman & Abraham, 2008). Psychological research on CS originally focused on the characteristics of adults undergoing it, as well as the psychosocial outcomes of cosmetic procedures (e.g. Crerand, Cash, & Whitaker, 2006). More recently, researchers have investigated factors associated with attitudes towards CS, such as self-objectification (Calogero, Pina, Park, & Rahemtulla, 2010), celebrity worship (Maltby & Day, 2011), dieting frequency (Schofield, Hussain, Loxton, & Miller, 2002), and materialistic values (Henderson-King & Brooks, 2009). A qualitative study investigating the reasons for women seeking breast reduction found that pain, body image, and self-esteem were all factors contributing to women’s desire for such a procedure (Reardon & Grogan, 2011). Researchers have also begun to examine the impact of media portrayals of CS. However, such investigations typically involve adult populations. In young women aged 19 years, Markey and Markey (2010) showed that more favourable attitudes towards CS reality television were associated with greater interest in pursuing surgery. In addition, watching an episode of a CS program led to a greater desire for CS. Similarly, Mazzeo and colleagues found that exposure to a CS makeover program led women to report increased perceptions of media pressures to be thin and stronger endorsement of their capacity to
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