Attitudes towards cosmetic surgery vary from country to country, and they also change over time. People who opt to have cosmetic surgery can’t be neatly labelled or stereotyped. Rather than sitting in judgment over others’ motivations, perhaps we should examine what has contributed to shaping and forming our own attitudes towards cosmetic surgery.

When we talk about attitudes about cosmetic surgery, we have to consider both the attitudes of people opting to undergo cosmetic surgery and the attitudes about this group by everyone else. It’s impossible to do this without also investigating what makes people seek elective cosmetic surgery in the first place.

Why do people opt for cosmetic surgery?

It‘s easy to suppose that it’s all about vanity, narcissism, shallowness and priorities that place too high a valuation on superficial beauty. But is it really that simple?

We also like to think about cosmetic surgery as just another way of enhancing our personal brand. That means it becomes just another tool, like education, qualifications, PR, image and how we want to project ourselves to others.

On a different level, people like to feel comfortable and confident in their own skin. Some people who have undergone cosmetic surgery say they’d rather have the surgery than obsess to distraction about the things they’d like to change.

Thinking about a body part to complete distraction has a name: Body Dysmorphic Disorder. It’s a mental disorder in which the sufferer is never satisfied with how he or she looks and will go to extreme lengths to change their appearance. But only a few people who opt for cosmetic surgery fall into this category. Everybody else must have a compelling reason to shell out large amounts of money in search of subtle or not so subtle changes to their face and body.

Different things motivate different people, because we are all innately different. However, in a 1943 paper, Abraham Maslow described stages that most humans pass through and what motivates them at each stage. According to Maslow’s theory, now a mainstay in management and motivation theory, our needs build and layer on one another like a pyramid until the pinnacle is reached.

At the most basic levels are physiological needs, for food, water, sex, the need for safety and security and the need for belonging and love. Beyond these there are the needs for esteem and self-actualisation.

Self-esteem, confidence, the need for achievement, and the need for respect fall in the esteem category. At the highest level, according to Maslow, the need for what he called self-actualisation—making our dreams come true and realising our true potential—is at the top of the pyramid. In modern thinking, morality, creativity, spontaneity, problem solving, lack of prejudice and acceptance of facts are grouped here. When people who have reached the top of their careers, they might write a book or start a charitable foundation or stay at home to enjoy their grandkids and watch the sunset.

Maslow’s Hierarchy of Needs helps us explain the many reasons people want cosmetic surgery and understand exactly where they fit. The vast majority are not seeking huge transformations through cosmetic surgery. They look for subtle changes that even their loved ones may not notice. Certainly there are people who imagine that their lives, relationships and prospects will all be vastly improved or transformed by elective surgery. As we know, they are in for great disappointment.

Most people seeking cosmetic enhancements belong in the middle of the pyramid. They want better self-esteem and more self-confidence. Even those who want to burnish their marketability in the job market to reach a higher rung or maintain their current status are in this group. These are all valid reasons for wanting cosmetic surgery.

After all, there is evidence that looking comparatively more attractive pays better, even in professions that do not require good looks. In May 2009, the Journal of Applied Psychology published a paper— Does it pay to be smart, attractive, or confident (or all three)?—by researchers from the Department of Management in the University of Florida, Gainesville. Their conclusion: “Overall, the results suggest that looks (physical attractiveness), brains (intelligence), and personality (core self-evaluations) are all important to income and financial strain.”[1]

Some reasons given as justification for cosmetic surgery may appear superficial to others. But who are we to judge the wannabe starlet and the greying middle manager wanting to get that slight competitive edge with the help of the surgeon’s knife? We all live in a society that values appearance. We may think this is a flaw in our society, but we still go along with it.

“People have surgery not to impress others. They do it to impress themselves,” renowned Australian plastic surgeon Bryan Mendelson recently told UK’s Daily Telegraph. Dr Mendelson, a past president of the International Society of Aesthetic Plastic Surgery, has over 25 years of experience in the field. He was in the UK promoting his book, In Your Face, which explains, through life stories, why women and men opt for elective cosmetic surgery. “For many people, it’s about getting their confidence back.”

He told the Telegraph’s Louisa Peacock that most of his patients don’t tell their families and significant others about their cosmetic surgery procedure. “99.99pc of my patients hide eyelid surgery, chin tucks and other facial operations from their husbands and kids. Patients’ husbands tend to freak out about surgery, saying ‘I love her the way she is, why would she risk doing that?’“ Dr Mendelson believes it is about self-esteem:  “They’re doing it for themselves.”

Obviously there is an element of shame in the need to keep it secret. Otherwise why keep it hidden? And studies have shown that this is so. People keep their cosmetic procedures secret because others tend to be judgmental about having or wanting to have cosmetic surgery.

Our attitude towards cosmetic surgery needs a sharp facelift,” declared Leslie Cannold in an article published in The Age in August 2007. The Age described the writer as “a reconstructed feminist, ethicist and author and an honorary senior lecturer at the Centre for Gender and Medicine at Monash University.”

She discusses the dilemma of being a feminist and wanting cosmetic surgery. And explains why a lot of women don’t want to talk about their procedures:

“Here are my guesses. First, no one wants to be thought vain. Indeed, for women such a slur carries

extra punch because vanity—with all its connotations of immodesty and triviality— has long been seen as evidence of women’s diminished moral capacities.

Fear of being tagged a failed feminist also keeps us quiet. Despite the hype, the vast majority of educated well-resourced women still identify with the women’s movement, and at the heart of feminist critiques of what Naomi Wolf called the beauty myth are claims about women’s rights to be seen, heard and recognised for what we do, not what we look like.”

Give the whole piece a read, it’s really worth it.

Earlier this month, Kate Fridkis, a writer and blogger at Eat the Damn Cake penned a piece, “In Defence of Plastic Surgery, for Daily Life”.  Fridkis begins her column with an accurate description of the stereotypes that colour our attitude towards plastic surgery:

“When people imagine someone who has had plastic surgery, they often imagine a woman with pushed up, too-round breasts and a stretched, unnatural face. There is something sad about her. It is sad that she “needs” it. It is sad that she is vain enough to get it. She lacks character, she has the wrong priorities, she is admitting defeat. She is, above all, superficial.

No one can ever guess by looking at me.”

That’s the thing. It is hard to put people in a box and stereotype them. Neither women fit the ‘superficial’ label. It is unfortunate that Fridkis’s recent experiences aren’t vastly different from those of Dr. Cannold’s five years ago. However, we’d like to believe that Australians’ attitudes on this front have moved forward in that time. By coming out openly and explaining their points of view and their motivations as strong, empowered and accomplished women, both have done a service to the thousands of Australian women who have surgery in silence.

[1] Judge TA, Hurst C, Simon LS. Does it pay to be smart, attractive, or confident (or all three)? Relationships among general mental ability, physical attractiveness, core self-evaluations, and income. J Appl Psychol. 2009 May;94(3):742-55. doi: 10.1037/a0015497. Accessed on 20 June 2013 at http://www.ncbi.nlm.nih.gov/pubmed/19450010

Global attitudes towards cosmetic surgery

As in Australia and around the world, more and more people are choosing to undergo cosmetic surgery. But despite the undeniably steep popularity trends, acceptance of cosmetic surgical procedures is still far from universal.    Back in December 2012, the Daily Telegraph in the UK reported on a survey, which found that a high number of women in the UK would shun plastic surgery even if it were offered for free. Out of the 750 women who responded to the beauty retailer Fabriah.com survey, 44 percent of the women said they’d opt for surgery even if it came with a heavy price tag. But they would only do it if they could be sure the surgery would make them attractive and younger looking.

Is it something in the water over there? Gwyneth Paltrow, who turned forty last September and lives in the UK with her family, recently told Harper’s Bazzar that she’s probably tried everything. However, “I would be scared to go under the knife, but you know, talk to me when I’m 50. I’ll try anything,” she said. The magazine reported that Paltrow had already tried thermage and loved it. She had also had anti-ageing treatments, but “I won’t do Botox again, because I looked crazy. I looked like Joan Rivers!”

Next, we look at the US, Gwyneth Paltrow’s birth country. In April 2011, the American Society for Aesthetic Plastic Surgery released the results of a 2010 survey which showed more than half (51%) of all Americans, regardless of income level, approve of cosmetic plastic surgery. This was a three percent increase from the previous year. The approval rates for cosmetic surgery are high among both women (53%) and men (49%). In particular, the survey showed that 52 percent of respondents with an income of under $25,000 approved of cosmetic surgery. Nearly three in ten (29%) belonging to the same income bracket would consider cosmetic surgery themselves. The approval rates for cosmetic surgery dropped slightly as income levels rose between $25,000 and $75,000—with 48% of respondents who earned between $25,000 and 50,000, and 45% of those earning between $50,000 and 75,000 approving cosmetic surgery.

Other findings from the survey:

  • Nearly seven out of ten (67%) Americans would not be embarrassed if their friends and family knew they had cosmetic surgery.
  • 27% of married Americans and 33% of unmarried Americans would consider cosmetic surgery for themselves, now or in the future.
  • Two out of ten surveyed said that their attitude towards cosmetic surgery had become more favourable in the last five years. However, the majority of Americans (71%) said their attitude had not changed in that time period.
  • The most likely age group to consider cosmetic surgery for themselves now or in the future were men and women between 18 and 24.
  • According to the survey 77% of those in the 65+ age group said they would not be embarrassed about having cosmetic surgery.

The president of The American Society for Aesthetic Plastic Surgery (ASAPS), Felmont F. Eaves III, MD summarised overall American attitudes towards cosmetic surgery by saying “… people in every income bracket, single or married, male or female, view plastic surgery as a reasonable option today.”

A paper published in the Journal of Social Psychology last year found that the attitudes towards cosmetic surgery patients across multiple cultures were predominantly negative. According to the researchers from the Hong Kong University of Science and Technology who looked at attitudes in Hong Kong, Japan and the United States, the survey participants in Hong Kong and Japan were “not willing to form social relationships, particularly intimate ones, with cosmetic surgery patients”. The attitudes were less negative in the United States “partly because social contact, which reduced negativity in attitudes toward cosmetic surgery patients, was more prevalent in the United States”. Having to face such negativity can have a direct impact on the cosmetic surgery patients because they often expect improvements in their social lives and relationships after cosmetic surgery.[1]

[1] Tam KP, Ng HK, Kim YH, Yeung VW, Cheung FY. Attitudes toward cosmetic surgery patients: the role of culture and social contact. J Soc Psychol. 2012 Jul-Aug;152(4):458-79. Accessed on 17 June 2013 at: http://www.ncbi.nlm.nih.gov/pubmed/22822685.

How about you?

What do you think about cosmetic surgery? How about non-surgical treatments? Would you hide the fact that you’ve had surgery or would you be open about it? Tell us in Comments. We’d like to know.

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