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another may lead to further surgeries. In this sense, having a first cosmetic procedure was viewed as crossing a threshold: ‘With cosmetic surgery, you can have one thing done and then you think there's another thing [to be] done, and another, and it just goes in one big circle’ and ‘I think it could become a bit of an obsession...and it can really get out of hand.’ Girls had mixed views over whether they would ever consider surgery themselves. Some said they would seriously consider it, with specific procedures already in mind; some categorically rejected the possibility of it both now and in the future; while others stated that they would consider it, but probably never go through with it: ‘I'd go for rhinoplasty, and then laser eye surgery, veneers, Botox, and that’ or alternatively, ‘I wouldn't do it, but I have nothing against it, if one of my friends got it done, it wouldn't even shock me anymore...I know quite a lot of people that have had things done and it's quite normal now’. As this last quote indicates, although girls differed in whether they would personally consider surgery, they believed a large proportion of their peers, ranging from 40 to 75 per cent, would consider having surgery. Importantly, girls thought the main barrier to their peers having surgery was cost rather than the risks involved in CS: ‘I think everyone would consider it at some point, even if they wouldn't take it further than just a quick thought...everyone has their things they don't like about themselves’, ‘If it wasn't a money issue, I think a lot of people, a scary amount of girls would do it.’ In response to a hypothetical scenario of undergoing a procedure there was a contrast between girls believing they would feel negatively about themselves following surgery because “it’s lazy” and “an easy option”, yet perceiving positive benefits of surgery: ‘I think I'd feel worse if I had plastic surgery 'cos I'd feel fake and that it wasn't actually me, and that people would look at me and think “oh she's done plastic surgery”...and in a bad way.’ Positive expectations of what CS would do for them included psychological benefits, such as improvements in self-confidence and self-esteem: ‘Confidence and feeling more secure within yourself when you go out, like when you RUNNING HEAD: Adolescents’ views on cosmetic surgery 13 go clubbing, feeling a lot better about yourself.’ Some girls had even stronger expectations, viewing surgery as a marker of a “new start” in a person’s life, as well as the creation of a “new life”. Finally, girls mentioned benefits in terms of social life and being seen as more attractive by others. ‘You see people and they're all slim with big boobs, I know it's really pathetic, but they get all the lads, they have lots of friends, they're confident - it's that perception of the whole thing. Yeah, I'm quite a confident person, but that would just give me the extra boost.’ Theme 4. Cosmetic surgery in the media. “It’s shoved in our faces” This theme summarises girls’ views of how CS is portrayed within the media and its influence. Girls thought CS is widely covered in the media, saying “it’s everywhere” and “shoved in our faces”. In their views, CS coverage has become standard in certain media. ‘I think it's like the norm now...you wouldn't pick up a magazine and go ‘oh my’ because there's surgery in there...you see it every day. There's always another celebrity saying they've had surgery and it's helped them or...stories about regular people as well that have had it.’ There was a strong consensus that the risks and dangers associated with CS are not adequately covered in the media. In cases where such risks are covered they tend to be in the form of extreme stories, rather than portraying the more common side-effects and complications: ‘They don't state the dangers of it, they just show how you could look, and the best things that come out of it, but they don't say that you could die...it's only the good bits’. Other girls commented ‘They only show the extremes of it...[when] surgery goes really wrong, or when people have gone over the top with it’ and ‘they don't show the small things. They don't show the fact that you could have pain, or headaches, or sickness...they won't show that 'cos it's not extreme enough. So they'll either show it perfect or really bad.’ Surgery was viewed as being glamorised by the media. This glamorisation and focus on the positives of CS in the media was perceived to lead to greater acceptance and desire for surgery: RUNNING HEAD: Adolescents’ views on cosmetic surgery 14 ‘You see more pros than cons, and when you see pictures of it…they airbrush the whole body to make it look perfect...and then you're like “I want that, I want to look like that!”’Another girl commented ‘They're trying to make surgery look glamorous, they try to make it look like a good thing, like everyone should be having it 'cos it's the ‘in’ thing, but...it's still surgery! If they actually told the whole story, I think people's opinions would change completely - so they wouldn't think it's such a good thing.’ Media coverage was also perceived as normalising CS, as well as setting standards for acceptable appearance: ‘It’s just the norm now…because it got so big, it’s not a big deal anymore, people just have it’ and ‘It sets a benchmark, if you don’t look like this, it’s not acceptable.’ Interestingly, girls denied the media influenced or put pressure on them to have CS, yet believed that other girls their age are quite strongly influenced by
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