Open Access Review Article

Social Media Influence on Body Image and

Cosmetic Surgery Considerations: A Systematic
Review began 07/19/2024
Review
Review ended 07/23/2024
Published 07/29/2024 Andreea Mironica 1 , Codruța Alina Popescu 2 , Delaca George 3 , Ana Maria Tegzeșiu 4,
Claudia Diana Gherman 5
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University of Medicine and Pharmacy, Cluj-Napoca, ROU

DOI: 10.7759/cureus.65626 Corresponding author: Codruța Alina Popescu, cpopescu@umfcluj.ro

Abstract
Social media platforms like Instagram (Meta Platforms, Inc., Menlo Park, California, United States) and
Snapchat (Snap Inc., California, United States) significantly influence motivations for aesthetic surgery by
promoting idealized and digitally enhanced images. Understanding their impact on body image
dissatisfaction and acceptance of cosmetic procedures is crucial. A systematic review following Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines explored the link between
social media, body image dissatisfaction, and cosmetic surgery. The review included 25 studies with 13,731
participants. Specific findings revealed that 70% of young adult women and 60% of young adult men report
dissatisfaction with their bodies, leading to increased surgical considerations. The search process utilized
databases such as PubMed, ScienceDirect, and Google Scholar, employing keywords like "cosmetic surgery,"
"social media," and "body image dissatisfaction" for articles published between January 2013 and December
2023. Both men and women show increased dissatisfaction with body parts, leading to surgical
considerations. Social media's emphasis on visual aesthetics fosters body dissatisfaction and social
appearance anxiety, especially through selfies. Cultural norms and celebrity influence further shape beauty
perceptions. While social media promotes cosmetic surgery acceptance, ethical concerns about misleading
advertisements, unrealistic beauty standards, and patient privacy persist. This underscores the need for
strategies to promote healthy body image and informed choices in the digital age.

Categories: Psychology, Public Health, Plastic Surgery

Keywords: plastic surgeons, aesthetic treatment, and body image dissatisfaction, social media, cosmetic surgery

Introduction And Background

Social media interaction plays a crucial role in shaping individuals' perspectives and motivations for
pursuing aesthetic surgery. As platforms like Instagram (Meta Platforms, Inc., Menlo Park, California, United
States) and Snapchat (Snap Inc., California, United States) continue to influence societal norms and beauty
standards, understanding their effects on body image dissatisfaction (a person's negative perception and
feelings about their own body, particularly its appearance) and the acceptance of cosmetic procedures
become increasingly important. Despite the growing body of research, there remain specific gaps in the
literature, particularly regarding the nuanced ways in which different demographics are affected and the
psychological mechanisms underlying these influences. This review aims to fill these gaps by systematically
exploring how social media contributes to the desire for cosmetic surgery (a branch of plastic surgery that
involves elective procedures aimed at enhancing or altering a person's appearance) across various
populations [1,2,3].

Social media has become a primary channel for social communication, offering users opportunities to
engage actively with appearance-related content from peers and celebrities. Unlike traditional media, these
platforms allow for dynamic interaction, comparison, and discussion, which can significantly impact body
image and interest in cosmetic surgery. Recent research indicates that increased exposure to cosmetically
enhanced images on social media can elevate an individual's desire for cosmetic procedures [4,5].

Body dissatisfaction and social appearance anxiety (the fear or concern about how one's appearance is
evaluated by others in social situations) are significant factors driving the decision to undergo physical
modifications. Psychological and sociocultural influences affect how young adults perceive and feel satisfied
with their body shape and size, with no specific gender, age, ethnicity, or status being immune to these
effects. Studies show that both men and women exhibit increasing discontentment with certain body parts,
leading to considerations for cosmetic surgery [1,6-8].

The practice of taking and editing selfies, particularly among younger demographics, further exacerbates

How to cite this article

Mironica A, Popescu C, George D, et al. (July 29, 2024) Social Media Influence on Body Image and Cosmetic Surgery Considerations: A
Systematic Review. Cureus 16(7): e65626. DOI 10.7759/cureus.65626
 body dissatisfaction. Regular engagement in such activities can lead to increased focus on body shape, lower
self-esteem, and, in severe cases, contribute to the development of body dysmorphic disorder, a psychiatric
condition characterized by an obsessive concern over perceived flaws in appearance [9-11].

Given the prevalence of idealized bodies on social media and the availability of photo editing tools,
individuals are often motivated to seek cosmetic surgery to achieve an appearance closer to their edited
images. This trend highlights the mutual reinforcement between social media use and body image concerns,
with significant implications for psychosocial well-being and happiness [12].

For more detailed definitions and distinctions of different social media platforms and their specific impacts,
we can delve into the unique features and influences of Instagram and Snapchat in contrast to traditional
media. For example, Instagram's focus on photo sharing and the extensive use of filters can establish high
beauty standards, whereas Snapchat's ephemeral content fosters different types of social interactions and
pressures. By comparing these platforms to traditional media, such as television and magazines, we can
highlight the distinctive ways in which social media's interactive and user-generated content uniquely
affects body image and cosmetic surgery considerations.

Understanding the connection between social media, body image dissatisfaction, and the consideration of
cosmetic surgery across various demographics offers valuable insights into the decision-making processes
for aesthetic procedures. This research highlights the importance for parents, clinicians, and policymakers to
acknowledge social media's influence on body image dissatisfaction and the desire for cosmetic
enhancements. Additionally, it calls for strategies to promote a healthy body image and self-acceptance in
the digital age. The study aims to clarify these relationships to enhance discussions between patients and
physicians regarding surgical outcomes and expectations.

Review
Materials and methods
Study Protocol

The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guidelines to identify relevant studies on the link between social media, body image
dissatisfaction, and cosmetic surgery consideration.

Inclusion and Exclusion Criteria

The inclusion criteria were studies that identified one or more potential predictive factors of social media on
body image dissatisfaction and attitudes toward cosmetic surgery. In this systematic review, studies that
focused solely on individuals with body dysmorphic disorder or studies that did not directly assess the
relationship between social media and body image dissatisfaction and/or attitudes towards cosmetic surgery
and studies where full text was not available were excluded. Articles such as conference abstracts, editorials,
and articles not written in English were also excluded.

Search Strategy

In our study, we conducted a comprehensive search across three major databases: PubMed, Science Direct,
and Google Scholar. We specifically searched for English-language full-text articles published from 1 January
2013 to 1 December 2023. The search terms included the Mesh term "aesthetic surgery" and the keywords
"cosmetic surgery," "social media," and "body image dissatisfaction." Additionally, we employed a
combination of Boolean operators to refine our search further.

The search strategy is presented in Figure 1.

2024 Mironica et al. Cureus 16(7): e65626. DOI 10.7759/cureus.65626 2 of 15

 FIGURE 1: PRISMA flow diagram
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Quality Assessment

Two reviewers conducted an assessment of study quality using the criteria outlined, and any discrepancies
were addressed through discussion. To ensure a robust quality assessment, we utilized specific criteria,
including study design, sample size, assessment tools, and the clarity of reported results. Each study was
scored based on these criteria to evaluate its methodological rigor and relevance to our review. Each study
was individually assessed across four categories: sampling technique, predictive factors, and analysis.
Studies that did not meet the preset criteria in these categories were omitted when drawing conclusions.

Data Extraction

Two reviewers independently extracted data from the studies using a standard template, including sample
size, study design, participant characteristics, assessment scale, and predictor variables related to body
satisfaction and acceptance.

Results
This review included 25 studies with a total of 13731 participants; more details about demographics are
presented in Table 1.

2024 Mironica et al. Cureus 16(7): e65626. DOI 10.7759/cureus.65626 3 of 15

 First
Design and aim of the Sample size and demographics Attitudes, acceptance, interests, perceptions, Considerations, practices, and
author Salient findings
studies and beliefs intentions
and year

Experimental randomized

parallel group; the study aims

to investigate the effects of

The study demonstrates that Instagram The study demonstrates that Instagram
exposure to sexualized 247 Italian young females; mean Practical interventions, such as media literacy
sexualization leads to increased body sexualization leads to increased body
Guizzo imagery and appearance- BMI 22.00; mean age 23.36 years; education and body-positive content, can mitigate
dissatisfaction among young females, indicating a dissatisfaction among young females,
2021 [13] related comments on 38% Bachelor degree students the negative impacts of Instagram on body
negative attitude toward body image influenced by indicating a negative attitude toward
Instagram on young women's 61%. image.
social media. body image influenced by social media.
body satisfaction and

intentions to undergo cosmetic

surgery.

Cross-sectional study; aimed

The intention is to use Instagram and Social media platforms facilitate active
to evaluate the attitudes and 524 Saudi participants; 56.9% There is significant interest in social media
Alghamdi Snapchat as effective marketing tools, engagement between organizations and
practices related to cosmetic females; and 61.6% Bachelor's advertising and recommendations from celebrities
2020 [14] with a focus on influencer marketing to consumers, enhancing satisfaction and
surgery among university degree. and bloggers.
engage young consumers. influencing purchasing decisions.
students in Saudi Arabia.

Experimental study; aimed to Women low in appearance-related self- The study underscores the influence of the media

investigate the impact of 145 women, mean age 23.07; Women with materialistic values perceive the discrepancies are more likely to consider environment on attitudes towards cosmetic

Ashikali cosmetic surgery advertising 79.3% white; mean BMI was intrapersonal benefits of cosmetic surgery surgery when exposed to risk surgery, suggesting that the frequency and style

2017 [6] on Swiss women's body image 21.00: 9% underweight, 85.5% differently depending on the nature of the information, highlighting the role of of advertising in different countries (UK vs.

and attitudes towards cosmetic normal weight, 5.5% overweight. advertisement they are exposed to. personal dissatisfaction and risk Switzerland) could affect how women respond to

surgery. perception in surgical considerations. such ads.

Cross-sectional study; aimed There is a reported high acceptance of cosmetic The study reveals that components of Over-identification, a component of self-

to evaluate the effect of surgery within the study sample, with a notable self-compassion, particularly over- compassion, was found to significantly predict
Conboy 107 women; aged between 18-29,
different social media (SM) interest in dermal fillers, highlighting a trend identification, play a critical role in positive attitudes towards cosmetic surgery,
2023 [4] 99% White.
platforms on plastic cosmetic influenced possibly by celebrity culture and media predicting attitudes toward cosmetic suggesting a nuanced interplay between self-

surgery in Saudi Arabia. exposure. surgery. awareness and media influence.

Cross-sectional study; aimed The study suggests that the way social
The study suggests that the way social media The initial hypothesis that active social media
to explore whether social media influences men's body image and
Truasheim influences men's body image and cosmetic surgery engagement would predict cosmetic surgery
media engagement impacts 311 participants cosmetic surgery considerations might
2023 [8] considerations might be unique compared to its interest was not supported; instead, passive
men's interest in undergoing be unique compared to its influence on
influence on women. engagement showed a significant relation.
cosmetic surgery. women.

Cross-sectional quantitative People have a desire to change the perceived

Emotional problems such as depression,
study; the study aimed to weaknesses in their physical appearance due to
anxiety, and personality disorders Individuals with higher social appearance anxiety
Zhou explore the influence of social 275 responses; mean age 20.91 low body confidence. Social appearance anxiety
associated with cosmetic surgery. engage more in selfie-related behaviors and
2023 [15] appearance anxiety on social years; Men’s BMI was 22.34, influences aceptance of cosmetic surgery.
Intention to consume beauty products editing, leading to greater cosmetic surgery
media use, impulsive higher than women's BMI (20.36). Perception that cosmetic surgery can improve
with the expectation of improved intention.
consumption, and acceptance emotional well-being, despite potential physical and
appearance.
of cosmetic surgery. emotional risks.

Cross-sectional design; the

Public self-awareness enhances body
primary aim of this study was
dissatisfaction through the internalization
to examine the combined roles
Direct association between media portrayals and of muscularity standards but does not The study notes the absence of social media's
of mass media, significant
men’s body dissatisfaction, but not cosmetic influence the acceptance of cosmetic role in influencing attitudes toward cosmetic
Nerini others, and self-awareness 203 Italian men aged 18-35 years
surgery acceptance, suggesting men respond surgery. Private self-awareness is surgery among men, which contrasts with other
2023 [7] (both public and private) in with an average BMI of 22.79.
directly to media images without internalizing associated with reduced body research suggesting social media's significant
predicting body dissatisfaction
beauty ideals. dissatisfaction and a lower likelihood of impact.
and the acceptance of
accepting cosmetic surgery for social
cosmetic surgery for social
reasons.
reasons among young men.

Descriptive cross-sectional

survey; the primary aim of the Surgeons believe that social media presence Social media is increasingly being The study found no significant differences in

Mortada study was to evaluate the use influences patient’s decisions to undergo plastic incorporated into the professional lives of social media use among surgeons based on age,

2023 [16] of social media among Saudi 61 surgeons; 88.5% were male. surgery, with a majority thinking that exposure to plastic surgeons for marketing and gender, region of residence, or years of practice,

plastic surgeons and its plastic surgery on social media increases the branding purposes, with significant usage suggesting broad acceptance across diverse

influence on their private likelihood of patients choosing to have procedures. among those in private practice (70.6%). demographic groups.

practices.

Cross-sectional survey; the

2024 Mironica et al. Cureus 16(7): e65626. DOI 10.7759/cureus.65626 4 of 15

 study aimed to assess how

social media influences the

A significant percentage of participants Platforms like Snapchat and Instagram The visual impact of before and after images was
decision to undergo 205 participants 54.1% were
Obeid acknowledged the impact of social media on their are commonly used among the a dominant factor, affecting 76.1% of the patients,
rhinoplasty among Saudi single; 61.5% were employed;
2022 [17] decision to undergo rhinoplasty, highlighting a participants, with Snapchat being indicating a significant visual-driven decision-
patients, with a focus on the 91.2% were women; and had a
broad acceptance and interest in aesthetic particularly popular due to its privacy making process in cosmetic surgery
most used social media Bachelor’s degree (80.5%).
enhancements influenced by digital platforms. features. considerations.
platforms and the impact of

advertisements and before-

and-after photos.

The desire to improve appearance for selfies

Cross-sectional survey; the With 1654 participants; Saudi A majority of respondents (64.69%) found
A significant portion of participants (28.42%) and video conferencing, intensified by the
Taha study aimed to investigate the nationals (96.80%). Female information about rhinoplasty
reported being influenced by social media to COVID-19 pandemic, has significantly increased
2023 [18] influence of social media on 69.11%, age group of 18-30 predominantly on Snapchat, highlighting
consider rhinoplasty, primarily driven by images of the consideration for facial cosmetic procedures,
the decision to undergo years 64.27%; bachelor’s degree the platform's role in shaping cosmetic
celebrities before and after such procedures. particularly among those dissatisfied with their
cosmetic procedures. 68.74%. surgery considerations.
facial features.

Surgeons' advertisements on SM,

A substantial portion of participants, influenced by
Cross-sectional study; aimed showing before-and-after pictures, The interaction of photo-editing apps and SM
2248 participants; 46.2% of them social media, were more interested in cosmetic
to evaluate the effect of significantly influenced the decisions of exposure significantly correlates with the
AlBahlal belonged 21 to 30-year-old group, treatments compared to those who were not
different social media (SM) participants to seek consultations and increased desire for cosmetic surgery,
2023 [1] 71.2% were females, and 91.4% influenced by SM, showing a strong relationship (P
platforms on plastic cosmetic treatments, more so among those highlighting the impact of visual presentation and
were Saudi citizens. < .001) between social media influence and the
surgery in Saudi Arabia. influenced by SM than those who were aesthetic enhancements in decision-making.
interest in undergoing cosmetic treatments.
not.

Cross-sectional study; to 1449 Saudi females; 46.75% The majority of the participants used
The findings underline an evolving trend where
Alghonaim assess the impact of social were aged between 25 and 34 Instagram was notably the most influential platform social media, alongside family and
plastic surgeons increasingly leverage social
2019 [19] media on aesthetic procedures years; 55.09% were single; concerning aesthetic procedures, especially among friends' experiences, as their primary
media to enhance visibility, educate potential
among females in Riyadh, 77.29% held a Bachelor’s degree. the young adult demographic. information sources before deciding on
patients, and build a professional brand.
Saudi Arabia. aesthetic procedures.

Intentions to undergo cosmetic

procedures to correct perceived

Cross-sectional study; to 653 individuals; mean age 29.4 A significant interest in cosmetic procedures due to
deformities revealed by selfies, with 46% Increased frequency of encountering one's
Alkarzae investigate the impact of social yo; 25.1% were male and 74.9% dissatisfaction with appearance in selfies. 37.8% of
of those perceiving deformities photographic likeness due to social media,
2020 [20] media on cosmetic surgery were female; 35.8% were respondents expressed a desire to undergo
expressing a desire for surgical leading to heightened interest in cosmetic
decisions among women in married. 71.4% had a Bachelor’s cosmetic procedures due to selfies, with
correction. Bringing selfies to cosmetic surgery.
Saudi Arabia. degree. rhinoplasty being the most desired.
surgery consultations to illustrate

perceived deformities.

Cross-sectional study; to Social media advertisements significantly Exposure to cosmetic surgery advertisements
A significant number of female university students
assess the role of social influence the consideration of and influencer content on social media platforms
Arab 2019 816 Saudi participants; mean age are influenced by social media in their decision to
media in shaping cosmetic undergoing cosmetic treatments, with a can affect self-esteem and perceptions of
[2] 21.15. undergo cosmetic treatments, with nearly half
surgery decisions among preference for non-surgical procedures attractiveness, leading to increased interest in
reporting being swayed by advertisements.
young adults. among those affected. cosmetic procedures.

Cross-sectional observational

analytic study; the study

The study highlights a cultural shift in China, with
aimed to explore the
The study suggests that engagement in increasing acceptance of cosmetic procedures
associations between body talk 309 college students from There is an indirect association between
Wang discussions about body appearance on social among men, potentially influenced by celebrity
on social networking sites China;62.5% women and 37.5% SNS body talk and cosmetic surgery
2022 [21] media (SNS body talk) increases personal concern culture and possibly Western media ideals; the
(SNS), body surveillance, and men; average age of 18.98 years; consideration via the mediators of body
about body image, which in turn increases the study did not find any gender differences in how
body shame with the mean BMI 20.80. surveillance and body shame.
consideration of cosmetic surgery. these factors influence cosmetic surgery
consideration of cosmetic
consideration.
surgery among young adults in

China.

305 Caucasian Italian university Engagement with Instagram, especially

Cross-sectional study; to Activities such as taking, selecting, and editing Beyond Instagram, other sociocultural and
women aged 19–32 years; mean images related to celebrities, directly and
DiGesto investigate the psychological photos are a form of body checking, where women individual factors such as peer influence, family
BMI was 21.78; 94.6% were indirectly, increases the acceptance of
2022 [22] effects of social media on assess and compare their bodies against attitudes, and personal beliefs about physical
unmarried and 5.4% were married cosmetic surgery through mechanisms
body image among university sociocultural standards, influencing their appearance play crucial roles in shaping attitudes
or cohabiting; 97.2% were like appearance comparison and body
students. perceptions and acceptance of cosmetic surgery. towards cosmetic surgery.
students and 2.8% workers. dissatisfaction.

370 female undergraduates, with

Descriptive, cross-sectional The influence of celebrities on cosmetic surgery
196 from a South Korean
survey study; the primary aim acceptance is more pronounced in the U.S.,
university and 174 from a U.S. participants show a stronger positive attitude
of the study is to explore the South Koreans show a higher likelihood indicating that celebrity culture might play a
university in the mid-Atlantic towards celebrities than South Korean participants.
associations between attitudes of accepting cosmetic surgery, possibly larger role in shaping cosmetic surgery attitudes
Jung 2016 region of the US. The participants This positive celebrity attitude is associated with a

2024 Mironica et al. Cureus 16(7): e65626. DOI 10.7759/cureus.65626 5 of 15

 toward cosmetic surgery, the due to different societal norms or lesser in Western contexts; lower body appreciation
[23] were 86.8% White, 6.3% Asian, greater acceptance of cosmetic surgery in the U.S.
extent of celebrity worship, stigma associated with such procedures. significantly predicts a greater acceptance of
and 6.9% from other ethnic U.S. participants displayed greater body

and body image dissatisfaction cosmetic surgery, highlighting body image

backgrounds. The average BMI satisfaction than South Korean participants.
among South Korean and US satisfaction as a crucial factor in cosmetic surgery
was 19.56 for Korean participants

female college students. considerations.

and 21.74 for US participants.

Cross-sectional survey; the The study included 159

During the pandemic, patients have shown an
study aimed to examine the respondents, with a gender
increased inclination to undergo cosmetic surgery Psychological impact and mood levels The need for plastic surgeons to assess the
Padley psychological impact of the distribution of 73% females and
to enhance their appearance for video during the pandemic should be psychological motivations behind cosmetic
2022 [10] COVID-19 pandemic on body- 27% males. The average age was
conferencing. It is believed that constant exposure considered as factors influencing the surgery requests and to conduct further studies to
image perception and the 43 years, with 56% of participants
to one’s image during video calls can distort self- decision to seek cosmetic surgery. ensure patient safety and satisfaction.
resulting increase in requests based in the UK and 44% in Italy.
perception.
for cosmetic surgery.

Following influencers who underwent cosmetic

The more frequently young adults use
procedures does not significantly relate to
Observational analytic study; visual social media like Instagram and
470 responses; Dutch young acceptance, but this might be due to the content of Despite high perceived prevalence, actual
to examine the impact of TikTok, the more they consider cosmetic
Hermans adults between 18-25 yo; 44% the acceptance scale focusing on self-image interest in cosmetic procedures among young
social media on body image procedures. Passive social media use,
2022 [5] males and 55.6% females; 23.6% benefits. Young adults exhibit a relatively low adults is low, indicating a discrepancy between
and cosmetic surgery interest such as following influencers who had
higher education. interest in cosmetic procedures, particularly in perceived and actual popularity.
among young women. cosmetic procedures, correlates with
treatments less popular among younger
increased intention and normalization.
demographics, such as Botox.

Gender and age differences in intentions,

with younger respondents showing higher

Cross-sectional study; the Higher acceptance among older participants, acceptance for social reasons.

study aimed to assess the 1008 responses; mean age of unmarried groups, and those with chronic health Differences in practices across countries
AlGhadeer Significant association between high self-esteem
impact of self-esteem and self- 34.7 yo; 73.5% females; 76.2% problems. Interest in cosmetic surgery is influenced and cultures, with women comprising a
2021 [24] and high body appreciation, leading to lower
perceived body image on the were married; 85.3% participants by factors such as body image orientation, being large majority of cosmetic surgery
acceptance of cosmetic surgery.
acceptance of cosmetic were university graduates. teased for appearance, and knowing someone patients. Differences in practices across

surgery among Saudi adults. who had cosmetic surgery. countries and cultures, with women

comprising a large majority of cosmetic

surgery patients.

Experimental study; the study

The sample consisted of 118
aimed to examine whether
English women with an average Participants who regularly engage with social The inclination to pursue cosmetic Social media plays a more substantial role in
Walker exposure to images depicting
age of 20.71 years, comprising media and feel dissatisfied with their appearance surgery was somewhat influenced by influencing the desire for cosmetic surgery
2021 [25] facial cosmetic enhancements
50.9% White, 25.3% Asian, are more likely to consider cosmetic surgery in the viewing cosmetically enhanced images compared to body dissatisfaction, challenging
increases the desire for
10.1% Black, and 13.5% from future. versus travel images. some previous assumptions.
cosmetic surgery among
other ethnic backgrounds.
young women.

Cross-sectional study; the

The time spent on social media,
study aimed to investigate the
513 participants; mean age 28.54 especially 15 minutes before sleeping
Yahya impact of social media Social media is accepted as a significant influencer An increase in cosmetic surgeries from 17.2% in
yo; 90.1% were females; 57.1% and after waking up, is a critical factor
2020 [26] engagement on body image on physical appearance and cosmetic surgery 2014 to 18.2% in 2017, parallel with the rise in
were married; 69.9% were influencing cosmetic surgery decisions.
and the increased popularity of decisions. social media engagement.
university students or graduates. Intention to change body image to align
seeking cosmetic surgery in Al-
with an ideal influenced by social media.
Ahsa City, Saudi Arabia.

Cross-sectional survey; the Participants who spent less time on

Internal and external factors, such as emotional
study aimed to evaluate the 364 participants; mean age 27.4; Despite high social media usage, most participants WhatsApp and Twitter were less likely to
states and societal pressures, play a role in the
Sindi effect of social media mean BMI of 25.0; 60% were had no intentions to undergo cosmetic procedures, consider future cosmetic procedures,
decision to undergo cosmetic procedures. The
2023 [27] platforms on the decision- female; more than half are contrasting with previous literature. Makkah indicating platform-specific influences.
type of social media platform influences the
making process of the general undergraduates; most of the society's conservative nature may affect attitudes The most popular cosmetic procedures in
acceptance and consideration of cosmetic
population regarding cosmetic participants were Saudis. towards social media and cosmetic procedures. the studied population include dermal
procedures.
procedures. fillers and rhinoplasty.

There is a notable discrepancy between the

Increased willingness to undergo
perceived benefits and the reliability of the
Cross-sectional survey; aimed 80% of the population showed interest in cosmetic procedures due to social media
1,064 participants; 41.1% were information provided by social media regarding
Alhusaini to investigate the impact of undergoing cosmetic procedures, influenced by influence and negative self-views while
less than 25 yo; 82.1% were cosmetic procedures. The inclination towards
2022 [28] Snapchat use on self-image social media. Interest is driven by goals such as using social media. The potential
females; 74.9% were university cosmetic surgery is higher among older
and the inclination toward increasing social media followers and filtering self- complications post-surgery and their
degree holders; 49.1% single. participants, females, educated individuals,
cosmetic procedures. image on platforms like Snapchat. impact on the patient's quality of life are
married individuals, and those with previous
significant considerations.
cosmetic surgery history.

The text suggests that frequent selfie-editing is A weak and negative correlation was found

Quantitative study using perceived negatively, as it is associated with between the Photo Manipulation scale and self-

2024 Mironica et al. Cureus 16(7): e65626. DOI 10.7759/cureus.65626 6 of 15

 The intention behind the study is to
purposive sampling; to increased social appearance anxiety and lower esteem. Selfie-editing prior to online posting
explore and establish the correlation
investigate the relationships self-esteem. This implies an attitude that values significantly influenced social appearance
253 students; 56 male and 195 between selfie-editing, social
Jieh 2022 between selfie-editing natural appearance over edited selfies. Students anxiety, accounting for 5.5% of the variance. The
female; 204 undergraduate; 172 appearance anxiety, and self-esteem.
[12] behavior, self-esteem, and perceive a significant relationship between selfie- results contradict a past experiment suggesting
between 21-25 yo. There is also an intention to compare
social appearance anxiety editing and their social and psychological health. that selfie-editing reduces social anxiety. This
these findings with previous studies to
among university students in The belief that selfie-editing leads to negative discrepancy may be due to differences in the
identify consistency or discrepancies.
Malaysia. outcomes suggests a perception that the practice focus on immediate versus long-term effects of

is detrimental. selfie-editing.

TABLE 1: Summary of studies reviewed

BMI: body max index; Yo: years old; UK: United Kingdom; SM: social media; SNS: social networking sites

Factors Associated with Likeliness to Pursue Cosmetic Surgical Procedure

Social media influence: The pervasive nature of social media platforms such as Instagram and Snapchat
plays a crucial role in shaping individuals' decisions to undergo cosmetic procedures. These platforms are
highly visual, emphasizing appearance through images and videos. Users are constantly exposed to idealized
and often digitally enhanced images, setting high and sometimes unrealistic beauty standards. The constant
comparison with these images can lead to dissatisfaction with one's appearance. The engaging and
interactive features of social media, including likes, comments, and shares, further reinforce the desire to
conform to these standards, driving individuals to consider cosmetic enhancements to align with the
prevalent aesthetic ideals [5,14,17,18,19].

Selfie behavior: The behavior of frequently taking and editing selfies has become a common trend,
particularly among younger demographics. This practice is linked to higher considerations for cosmetic
surgery. The process of taking selfies often involves scrutinizing one’s appearance closely, identifying
perceived flaws, and using filters or editing tools to "improve" these features. Over time, this can lead to
increased body dissatisfaction as individuals become more aware and critical of their imperfections. The
desire to look better in selfies can translate into a willingness to undergo cosmetic procedures to achieve a
more polished and attractive appearance that can be effortlessly captured on camera [4,15,20].

Body dissatisfaction and anxiety: Anxiety over social appearance and body dissatisfaction are significant
predictors of the desire to undergo cosmetic surgery. Individuals who are unhappy with their bodies
are more likely to seek surgical solutions to improve their self-image. Social appearance anxiety, which
involves the fear of negative evaluation of one’s appearance by others, exacerbates this desire. The pressure
to meet societal beauty standards can lead to chronic anxiety and dissatisfaction, prompting individuals to
consider cosmetic surgery as a way to alleviate these feelings and improve their confidence and social
acceptance [2,7,15].

Cultural and societal norms: These factors heavily influence the perception of beauty and the acceptance of
cosmetic procedures. In regions with high exposure to Western beauty standards, there is often a greater
emphasis on certain aesthetic ideals, such as slim bodies, symmetrical facial features, and youthful
appearances. These norms are propagated through various media, including movies, advertisements, and
social media, creating a widespread belief in the desirability of these features. The pressure to conform to
these standards can be immense, leading individuals to seek cosmetic surgery to fit the cultural and societal
mold of beauty [21,23].

Celebrity influence: Celebrities play a significant role in shaping public perceptions of beauty and cosmetic
surgery. Their endorsements and visible transformations are highly influential, particularly on social media.
When celebrities undergo cosmetic procedures and publicly share their experiences and results, they
normalize these practices and make them more desirable to the public. Followers who admire these
celebrities may be motivated to undergo similar procedures to emulate their idols. The portrayal of flawless
celebrity appearances as achievable goals can significantly sway individuals' decisions to pursue cosmetic
surgery, viewing it as a legitimate and accessible means to enhance their own looks [5,22,25].

Positive Attitudes Toward Cosmetic Surgical Procedure

Enhanced appearance: Many individuals view cosmetic procedures to improve their physical appearance.
This perspective is rooted in the desire to address specific aesthetic concerns that may not be achievable
through natural means. Whether it’s correcting perceived imperfections, reversing signs of aging, or
enhancing certain features, cosmetic surgery provides a solution to attain desired looks. This enhancement
can lead to increased self-esteem and confidence, as individuals feel more satisfied with their appearance.
The notion that looking better can lead to feeling better is a significant driver behind the positive attitudes
towards cosmetic procedures [1,2,20].

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 Social media validation: In the age of social media, achieving a certain look for online approval is seen as a
benefit of cosmetic surgery. Platforms like Instagram and Snapchat place a high value on visual aesthetics,
and users often seek validation through likes, comments, and shares. Cosmetic procedures can help
individuals conform to the beauty standards prevalent on these platforms, thus enhancing their social
media presence. The positive feedback received from followers can further boost self-esteem and provide a
sense of social acceptance. For many, the ability to present an idealized version of themselves online is a
compelling reason to undergo cosmetic enhancements [5,14,17-19].

Emotional well-being: There is a belief that cosmetic surgery can lead to better emotional well-being despite
the potential risks involved. For individuals who struggle with body image issues or have long-standing
insecurities about their appearance, cosmetic procedures offer a way to alleviate these concerns. The
satisfaction derived from seeing a more desirable reflection in the mirror can translate to improved mental
health, reducing feelings of depression and anxiety related to body dissatisfaction. This improvement in
emotional well-being is often cited by proponents as a significant benefit of cosmetic surgery [10,15].

Negative Attitudes Toward Cosmetic Surgical Procedure

Risk awareness: Awareness of the potential physical and emotional risks associated with cosmetic surgery is
a major factor contributing to negative attitudes. Complications from surgery, such as infections, scarring,
and adverse reactions to anesthesia can deter individuals from pursuing these procedures. Moreover, the
results of cosmetic surgery may not always meet expectations, leading to dissatisfaction and regret. The
possibility of facing unmet expectations and the associated disappointment is a significant concern that
fosters skepticism towards cosmetic procedures [6,28].

Body image issues: Concerns about fostering negative body image and unrealistic beauty standards are
prevalent among critics of cosmetic surgery. The pursuit of an idealized appearance can perpetuate a cycle
of dissatisfaction, where individuals continually find new flaws to fix. This focus on physical perfection can
detract from the appreciation of natural beauty and individuality. Additionally, the promotion of certain
beauty standards through cosmetic surgery can lead to societal pressures, making others feel inadequate if
they do not conform. These issues highlight the potential negative impact of cosmetic procedures on overall
body image [6,15,20].

Psychological impact: Elevated rates of depression, anxiety, and personality disorders are observed among
those considering cosmetic surgery. The desire to undergo these procedures often stems from deeper
psychological issues related to self-worth and identity. For some, the temporary boost in self-esteem
provided by cosmetic enhancements may not address the underlying causes of their dissatisfaction. Instead,
it can lead to a dependence on surgical solutions to manage emotional distress. The psychological toll of
cosmetic surgery, including the potential for post-operative regret and the need for further procedures,
contributes to the negative attitudes surrounding these interventions [10,15].

Acceptance of Cosmetic Surgical Procedure

High acceptance: Cosmetic surgery enjoys a high acceptance rate, particularly among younger demographics
and active social media users. This trend can be attributed to several factors. Firstly, the youth are generally
more receptive to new trends and are significantly influenced by the visual culture of social media. Platforms
like Instagram and TikTok (ByteDance Ltd., Beijing, China) propagate idealized images of beauty, often
enhanced by cosmetic procedures. Young people, exposed to these standards daily, may seek cosmetic
surgery to align their appearance with these ideals. Moreover, social media fosters a culture of constant self-
presentation and comparison, which can intensify desires to meet specific aesthetic standards. The
validation received through likes and positive comments post-surgery further reinforces the decision to
undergo cosmetic enhancements [5,24].

Cultural differences: Acceptance of cosmetic surgery varies significantly across different cultures, influenced
by societal norms and the level of stigma associated with such procedures. In some cultures, cosmetic
surgery is seen as a routine and acceptable means of improving one’s appearance. For example, South Korea
has one of the highest frequencies of cosmetic surgery procedures globally, with procedures deeply
embedded in societal norms and widely accepted. Conversely, in more conservative societies, cosmetic
surgery may be less common and more stigmatized. However, globalization and the proliferation of Western
beauty ideals through media have led to increasing acceptance in many regions traditionally resistant to
cosmetic enhancements. The cultural context thus plays a crucial role in shaping attitudes toward cosmetic
surgery [21,23,27].

Influence of education and marital status: Acceptance rates of cosmetic surgery are also higher among
individuals with higher education levels and those in different marital statuses. Education often correlates
with greater awareness and understanding of cosmetic procedures, including the potential benefits and
risks. Individuals with higher education often have greater access to information and resources, allowing
them to make well-informed decisions regarding surgery. Additionally, marital status influences acceptance,
with single individuals and those recently divorced showing higher rates of acceptance. These groups may be

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 more motivated to enhance their appearance, either to boost self-confidence or to attract new partners. The
interplay between education, marital status, and the desire for cosmetic surgery underscores the complexity
of factors driving acceptance [17,26,28].

Perception of Others Who Undergo Cosmetic Surgical Procedure

Admiration for improvement: Individuals who undergo cosmetic procedures often receive admiration for
their enhanced appearance. The visible improvements resulting from these procedures can elicit positive
reactions from peers, family, and society at large. This admiration is rooted in the effort and willingness to
invest in one's appearance, which is often seen as a form of self-care and personal enhancement. The post-
surgery results, whether subtle or dramatic, are typically viewed as successful attempts to achieve aesthetic
goals. This positive feedback can reinforce the decision to undergo cosmetic surgery, contributing to a cycle
of approval and increased self-esteem for those who have opted for such procedures [19,22].

Celebrity influence: The influence of celebrities and social media influencers who have undergone cosmetic
procedures significantly shapes public perceptions. When admired public figures share their cosmetic
surgery experiences and results, they contribute to normalizing these practices. Followers who look up to
these celebrities may develop positive views towards cosmetic surgery, seeing it as an acceptable and even
desirable means of enhancing one's appearance. This normalization is amplified by the transparency and
openness with which many celebrities discuss their procedures, often framing them as empowering choices
that align with personal or professional aspirations. The portrayal of cosmetic surgery by influencers can
thus foster a more accepting and positive attitude towards these enhancements among their audiences
[6,23].

Superficial judgments: Despite the positive admiration some receive, there is a prevalent negative
perception that individuals who undergo cosmetic surgery are superficial or overly concerned with their
appearance. This judgment stems from the belief that altering one's appearance through surgery indicates a
prioritization of looks over more substantive personal qualities. Critics argue that such individuals may be
focusing too much on external validation rather than internal growth or self-acceptance. This superficial
label can carry a stigma, suggesting that those who choose cosmetic surgery are more interested in vanity
than authenticity, potentially leading to societal disapproval or ridicule [22].

Unrealistic standards: Another significant negative perception is that cosmetic surgery promotes unrealistic
beauty standards. The enhanced and often idealized results of cosmetic procedures can set unattainable
benchmarks for beauty, leading to widespread body dissatisfaction. This issue is exacerbated by the
portrayal of post-surgery appearances in media and advertising, which often highlight flawless and
exaggerated outcomes. Critics argue that these representations contribute to a culture that values a narrow
and often artificial standard of beauty, pressuring individuals to undergo surgery to conform. This pursuit of
perfection can lead to a cycle of continual dissatisfaction and repeated surgical interventions, undermining
the appreciation of natural diversity in appearance [1,10,20].

The Surgical Profession

In the contemporary medical landscape, plastic surgeons increasingly leverage social media platforms for
marketing, enhancing visibility, and engaging with patients. Platforms such as Instagram, Facebook, and
TikTok enable surgeons to showcase their work through before and after photos, videos, and patient
testimonials, effectively serving as a dynamic portfolio that highlights their skills and the transformative
effects of their procedures. Additionally, social media offers an interactive space where potential patients
can ask questions, seek advice, and receive immediate feedback, fostering trust and credibility. This
interaction helps patients feel more informed and comfortable in their decision-making process. Surgeons
also utilize these platforms to stay updated with industry trends, connect with peers, and participate in
professional communities [1,14].

The majority of plastic surgeons believe that social media positively influences patient decisions and
significantly enhances the visibility of their field. By using social media, surgeons can reach a broader
audience, including individuals who might not have considered cosmetic surgery otherwise. The
transparency and accessibility of information on these platforms empower patients to make more informed
choices. Additionally, social media allows surgeons to share educational content, debunk myths, and provide
insights into the realities of cosmetic surgery. This proactive dissemination of knowledge helps demystify
procedures, reduce patient anxiety, and manage expectations. Overall, the consensus among surgeons is
that social media is an invaluable asset for their practice, facilitating growth and patient engagement [16].

However, the use of social media by plastic surgeons also raises important ethical considerations. Concerns
include the potential for misleading advertisements and the portrayal of unrealistic results, which can lead
to patient dissatisfaction and harm. The emphasis on aesthetic perfection propagated through social media
can contribute to body image issues and the pursuit of unnecessary surgeries. Ethical promotion requires
surgeons to maintain honesty and integrity in their posts, ensuring that the information shared is accurate
and balanced. Additionally, there are concerns about patient privacy and consent. Surgeons must obtain

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 proper consent before sharing any patient-related content and respect the confidentiality of patient
information [17].

Representation of Cosmetic Surgical Procedure in the Media

Social media platforms: Instagram and Snapchat have emerged as dominant platforms that significantly
influence perceptions and decisions regarding cosmetic surgery. These platforms are highly visual, allowing
users to share images and videos that emphasize appearance. On Instagram, the culture of aesthetic
perfection is prevalent, with users constantly exposed to images of idealized beauty standards. The use of
filters and editing tools on Snapchat also contributes to this phenomenon, as users can experiment with
altered versions of their appearance. The frequent display of enhanced looks creates a comparative
environment where individuals feel pressured to conform to these beauty ideals. The interactive nature of
these platforms, where users receive immediate feedback through likes and comments, further reinforces the
desire to attain similar results through cosmetic procedures [14,17,18].

Visual impact: The impact of visual content, particularly before and after images, is profound in driving the
decision-making process for cosmetic surgery. These images provide tangible proof of the potential
transformations that cosmetic procedures can achieve. Seeing dramatic improvements in appearance can be
highly persuasive, as it offers a clear and immediate representation of the benefits. Before and after photos
allow individuals to visualize the possibilities for their own bodies, making the decision to undergo surgery
more compelling. This visual-driven approach appeals to the desire for quick and noticeable results,
highlighting the effectiveness of cosmetic interventions. The allure of achieving a similarly impressive
transformation motivates many to pursue these procedures [13,16,28].

Advertising: Cosmetic surgery advertisements on social media are pivotal in influencing decisions, with a
significant number of participants reporting being swayed by such ads. These advertisements often feature
testimonials, endorsements, and visually appealing content that highlights the success of various
procedures. Social media algorithms also play a role in targeting potential candidates by showing ads based
on users’ interests and behaviors. The persuasive nature of these ads, combined with their frequent
appearance in users' feeds, can create a strong incentive to consider cosmetic surgery. Advertisements that
focus on the ease, affordability, and accessibility of procedures further reduce the barriers to making a
decision. The strategic placement and compelling content of cosmetic surgery ads contribute to their
effectiveness in shaping public perceptions and encouraging individuals to seek out these services [1,14,16].

Discussion
The influence of social media platforms like Instagram and Snapchat is significant in shaping individuals'
decisions to undergo cosmetic procedures. These platforms emphasize visual aesthetics, exposing users to
idealized and often digitally enhanced images, which can lead to dissatisfaction with one's appearance and
drive the desire for cosmetic enhancements [12,26,29,30]. The practice of taking and editing selfies,
particularly among younger demographics, further heightens body dissatisfaction and increases the
consideration for cosmetic surgery [1,16,20].

Body dissatisfaction and social appearance anxiety are major predictors of the desire for cosmetic surgery
[11,31]. Individuals unhappy with their bodies or fearing negative evaluation by others are more likely to
seek surgical solutions [2,15,32]. Cultural and societal norms, especially those emphasizing Western beauty
standards, also play a crucial role in influencing perceptions of beauty and acceptance of cosmetic
procedures [27,33,34].

Celebrities and social media influencers significantly shape public perceptions of beauty and cosmetic
surgery by normalizing these practices through their endorsements and transformations [4,5,23]. Positive
attitudes toward cosmetic surgery include improved physical appearance, increased self-esteem, and
enhanced social media validation [1,2,25,35,36]. However, there are negative attitudes due to awareness of
potential risks, fostering unrealistic beauty standards, and the psychological impact, including dependence
on surgical solutions for emotional distress [10,28].

Cosmetic surgery enjoys high acceptance, especially among younger demographics and social media users,
due to the influence of visual culture [24]. Acceptance varies across cultures and is higher among educated
individuals and certain marital statuses [17,26,28]. Despite some admiration for improved appearance post-
surgery, there are negative perceptions that cosmetic surgery promotes superficiality and unattainable
beauty standards [22].

Plastic surgeons increasingly use social media for marketing, showcasing their work, and engaging with
patients [37,38]. While most surgeons believe social media positively influences patient decisions and
enhances visibility, there are ethical concerns about misleading advertisements and patient privacy
[16,34,39]. Misleading advertisements can create unrealistic expectations and lead to patient dissatisfaction
when results do not match the portrayed outcomes. Expanding the discussion on these ethical concerns, it is
essential to highlight that misleading advertisements not only deceive potential patients but also undermine

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 trust in the medical profession. Surgeons must adhere to high standards of transparency and honesty in
their marketing practices. Additionally, patient privacy must be rigorously safeguarded, ensuring that all
shared content respects confidentiality agreements and is used with explicit patient consent. Furthermore,
patient privacy should be a top priority, with stringent measures in place to protect personal information
and maintain the integrity of the patient-doctor relationship. By addressing these ethical issues, the
cosmetic surgery industry can promote a more responsible and patient-centered approach, ultimately
enhancing the credibility and sustainability of the field. Overall, social media significantly impacts the
perception and acceptance of cosmetic surgery [17,18,28,34,40-42].

A more detailed critical analysis reveals several limitations and potential biases in the included studies.
Many studies rely on self-reported data, which can introduce response bias. The cross-sectional nature of
most research does not establish causality, only correlation. Additionally, the representation of various
demographics is often uneven, with a focus on younger, Western populations, limiting the general
applicability of the findings.

Potential biases in the review process include publication bias, where studies with significant findings are
more likely to be published. Language bias may also be present, as non-English studies were excluded.
Future reviews should aim to include a more diverse range of studies to mitigate these biases. Future
research should focus on conducting longitudinal studies to establish causality between social media use
and body image dissatisfaction. It is also important to include more diverse populations in terms of age,
ethnicity, and cultural background to improve the universality of findings.

Conclusions
Social media platforms like Instagram and Snapchat significantly influence the desire for cosmetic
procedures by promoting idealized images, which increase body dissatisfaction and social appearance
anxiety. Cultural norms and celebrity influence further shape beauty perceptions, leading to positive
attitudes towards improved appearance and negative concerns about risks and unrealistic standards. The
high acceptance of cosmetic surgery among younger demographics and social media users is evident. While
plastic surgeons effectively use social media for marketing, there are ethical concerns about misleading ads
and patient privacy. Overall, social media profoundly impacts cosmetic surgery perceptions, emphasizing
the need for informed and safe choices.

To mitigate these negative impacts, clinicians should implement body positivity programs and screen for
psychological conditions before cosmetic procedures. Policymakers need to enforce stricter advertising
regulations and support mental health programs addressing social media-related body image issues. Social
media platforms should promote body positivity, collaborate with mental health professionals, and establish
guidelines to limit the promotion of unrealistic beauty standards. These steps can help mitigate the negative
impacts of social media on body image and cosmetic surgery considerations, fostering a healthier and more
realistic perception of beauty.

Additional Information
Author Contributions
All authors have reviewed the final version to be published and agreed to be accountable for all aspects of the
work.

Concept and design: Andreea Mironica, Codruța Alina Popescu, Claudia Diana Gherman

Acquisition, analysis, or interpretation of data: Andreea Mironica, Codruța Alina Popescu, Delaca
George, Ana Maria Tegzeșiu, Claudia Diana Gherman

Drafting of the manuscript: Andreea Mironica, Codruța Alina Popescu, Delaca George, Claudia Diana
Gherman

Critical review of the manuscript for important intellectual content: Codruța Alina Popescu, Ana
Maria Tegzeșiu, Claudia Diana Gherman

Supervision: Codruța Alina Popescu, Claudia Diana Gherman

Disclosures
Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the
following: Payment/services info: This research was funded by UMF Cluj-Napoca, grant number 647/39/11
January 2024. Financial relationships: All authors have declared that they have no financial relationships
at present or within the previous three years with any organizations that might have an interest in the
submitted work. Other relationships: All authors have declared that there are no other relationships or
activities that could appear to have influenced the submitted work.

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