Adolescents, Celebrity Worship, and Cosmetic Surgery
2011; Elsevier BV; Volume: 49; Issue: 5 Linguagem: Inglês
10.1016/j.jadohealth.2011.08.014
ISSN1879-1972
AutoresAnisha Abraham, Diana M. Zuckerman,
Tópico(s)Empathy and Medical Education
ResumoSee Related Article p. 483The surge in TV shows, Web sites, and advertisements featuring cosmetic surgery has changed public perception of "ideal" beauty standards, raising expectations of beauty that are not obtainable by natural means [[1]Heyes C.J. Normalisation and the psychic life of cosmetic surgery.Aust Fem Stud. 2007; 22: 55-59Crossref Scopus (19) Google Scholar]. Popular procedures among adolescents in Western countries include nose reshaping, breast augmentation, and liposuction, as well as blepharoplasty or eyelid surgery in parts of Asia [2Plastic Surgery Procedural Statistics; Age Distribution: 13–19; 2010 American Society of Plastic Surgeons.http://www.plasticsurgery.org/Documents/news-resources/statistics/2010-statisticss/Patient-Ages/2010-teen-cosmetic-surgery-minally-invasive-13-19.pdfDate: 2010Google Scholar, 3Plastic Surgery Procedural Statistics; Age Distribution: 20–29; 2010 American Society of Plastic Surgeons.http://www.plasticsurgery.org/Documents/news-resources/statistics/2010-statisticss/Patient-Ages/2010-cosmetic-minimally-invasive-surgery-over-20-29.pdfGoogle Scholar, 4AAFPRSMembership Study, 2009 The American Academy of Facial Plastic and Reconstructive Surgery.http://www.aafprs.org/media/stats_polls/aafprsMedia2009.pdfGoogle Scholar, 5Wen H. Being good-looking is capital: Cosmetic surgery in China today.Asian Anthropol. 2009; 8: 90-104Google Scholar]. Researchers have noted an increase in media fascination with and reporting of celebrities who have elective procedures [[6]Sarwer D.B. Magee L. Crerand C.E. Cosmetic surgery and cosmetic medical treatments.in: Thompson J.K. Handbook of Eating Disorders and Obesity. Wiley, New York, NY2004Google Scholar]. Does the frequent attention focused on celebrities undergoing cosmetic surgery influence the behavior of adolescents who admire them? In this issue of the Journal of Adolescent Health, Maltby and Day demonstrate that teens who worship celebrities do not simply mimic their clothing and hairstyles, but also obtain elective cosmetic surgery more than those who do not worship celebrities.Cosmetic procedures have become pervasive, advertised in the mass media, and the subject of countless TV programs, such as Dr. 90210 (created in the United States but internationally known). The American Society of Aesthetic Plastic Surgery estimates that the number of children less than 18 years of age undergoing cosmetic surgery procedures by their members has ranged from 33,000 to 65,000 annually in the past 10 years, with nonsurgical cosmetic procedures ranging from 91,000 to 190,000 per year [[7]Cosmetic Surgery National Data Bank Statistics2000–2010 The American Society for Aesthetic Plastic Surgery.http://www.surgery.org/media/statisticsGoogle Scholar]. On a global scale, the possible reasons for increasing demand include higher disposable income, media portrayal, and reduced stigma [6Sarwer D.B. Magee L. Crerand C.E. Cosmetic surgery and cosmetic medical treatments.in: Thompson J.K. Handbook of Eating Disorders and Obesity. Wiley, New York, NY2004Google Scholar, 8Swami V. Arteche A. Chamorro-Premuzic T. et al.Looking good: Factors affecting the likelihood of having cosmetic surgery.Eur J Plast Surg. 2008; 30: 211-218Crossref Scopus (65) Google Scholar]. In addition to these factors, Maltby and Day find that adolescents' attitudes toward celebrities have a significant impact.Should the increase in elective cosmetic surgery among teens concern health professionals? Surgery to correct deformities such as cleft lip and palate has clear benefits. In contrast, procedures such as liposuction and breast augmentation among adolescents are much more controversial. There is no scientific evidence that surgery improves self-esteem or confidence in the long term, although it tends to increase satisfaction with the body part that was "fixed" [[9]Zuckerman D. Abraham A. Teenagers and cosmetic surgery: Focus on breast augmentation and liposuction.J Adolesc Health. 2008; 43: 318-324Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar]. Even without cosmetic procedures, satisfaction with appearance increases with age during adolescence [[10]Simis K.J. Hovius S.E. de Beaufort I.D. et al.After plastic surgery: Adolescent-reported appearance ratings and appearance-related burdens in patient and general population groups.Plast Reconstruct Surg. 2002; 109: 9-17Crossref PubMed Scopus (33) Google Scholar]. Cosmetic procedures can lead to medical complications, are extremely expensive, and often are not covered by insurance. There is the risk that initial procedures can lead to additional procedures either because of increased focus on achieving perfection or the need to correct an unsatisfactory procedure. Finally, the decision to undergo elective cosmetic surgery is associated with body dysmorphic disorder and low self-esteem [11Hass C.F. Champion A. Secor D. Motivating factors for seeing cosmetic surgery: A synthesis of the literature.Plast Surg Nurs. 2008; 28: 177-182Crossref PubMed Scopus (55) Google Scholar, 12Picavet V.A. Prokopakis E.P. Gabriëls L. et al.High prevalence of body dysmorphic disorder symptoms in patients seeking rhinoplasty.Plast Reconstr Surg. 2011; 128: 509-517Crossref PubMed Scopus (79) Google Scholar].In the Maltby and Day study, 137 young adults in two cities in the United Kingdom completed questionnaires regarding attitudes toward celebrities whose body image they admired, previous experiences regarding cosmetic surgery, and a host of psychological and demographic measures, such as measures of body shape, self-esteem, life satisfaction, and self-rated attractiveness. The age range of the participants was 18–23 years. Eight months later, subjects were asked to report whether they had undergone elective cosmetic surgery [[13]Maltby J. Day L. Celebrity worship and incidence of elective cosmetic surgery: Evidence of a link among young adults.J Adolesc Health. 2011; 49: 483-489Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar].The most frequent procedures reported by subjects were Botox, soft tissue fillers, breast augmentation, breast lift, laser skin resurfacing, and nose reshaping. After controlling for known predictors of cosmetic surgery, such as body-image preoccupation, self-esteem, sex, and previous cosmetic surgery, the researchers found that celebrity worship of an individual whose body was admired predicted the likelihood of cosmetic surgery. The practical consideration gained from the study is that providers should consider including a measure of celebrity worship when screening patients and discussing elective cosmetic procedures, in addition to discussing self-esteem, body image, and previous cosmetic surgery experience [[13]Maltby J. Day L. Celebrity worship and incidence of elective cosmetic surgery: Evidence of a link among young adults.J Adolesc Health. 2011; 49: 483-489Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar].The study does have limitations. Notably, 23% of the 18–23-year-olds reported having cosmetic surgery at baseline, which rose to 31% after 8 months. These percentages are considerably higher than those in the general young adult population. The authors explain that these rates reflect an intentional bias within the study sample, and generalizations regarding the prevalence for all adolescents are not possible. However, such limitations do not affect the study's findings about celebrity worship and other variables significantly associated with cosmetic surgery.The results shed light on celebrity worship as a potential risk factor for undergoing elective cosmetic surgery in late adolescence and early adulthood. This has important implications for our celebrity-obsessed and media-saturated society. The findings support the need for standardized screening, including for body dysmorphic disorder and psychological problems, before cosmetic surgery. Effective screening could potentially improve the process by which decisions are made about whether adolescents should undergo procedures. In addition, the authors report that the incidence of celebrity worship decreases as one ages. Given normal development regarding celebrity worship, self-confidence, physical development, understanding of risk factors, and other maturation issues, health professionals would do well to recommend that teenagers wait before undergoing procedures such as breast augmentation and liposuction.In demonstrating the link between moderate celebrity worship and cosmetic surgery, the researchers address one aspect of a much larger, complicated issue. What areas associated with adolescent cosmetic surgery still need to be examined? Longitudinal research is needed to evaluate the appropriateness of performing cosmetic surgery on patients whose bodies and cognitive development have not reached maturity, in terms of physical and emotional outcomes. Future research is also needed on cosmetic surgery and differences related to race, age, socioeconomic status, and ethnicity, as well as the comparative effectiveness of cognitive behavioral therapy and other approaches for adolescents with negative perceptions of their bodies [[9]Zuckerman D. Abraham A. Teenagers and cosmetic surgery: Focus on breast augmentation and liposuction.J Adolesc Health. 2008; 43: 318-324Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar].In addition to more research, there is certainly a need to develop guidelines involving screening and counseling by organizations that are actively involved in promoting the health and well-being of teenagers. Consent procedures for teens and their parents should be required to include a clear discussion of risks and benefits, photographs of adverse reactions, and a discussion of body image concerns and expectations of surgery [[9]Zuckerman D. Abraham A. Teenagers and cosmetic surgery: Focus on breast augmentation and liposuction.J Adolesc Health. 2008; 43: 318-324Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar]. Finally, young people should be encouraged to be more self-confident and accept their bodies as a whole, rather than conceptualizing themselves as a collection of body parts subject to surgical correction [[14]Calogero R. Pina A. Park L. et al.Objectification theory predicts college women's attitudes toward cosmetic surgery.Sex Roles. 2010; 63: 32-41Crossref Scopus (83) Google Scholar]. Data provided by Maltby and Day show there is much we need to do regarding cosmetic surgery and adolescents. See Related Article p. 483 See Related Article p. 483 See Related Article p. 483 The surge in TV shows, Web sites, and advertisements featuring cosmetic surgery has changed public perception of "ideal" beauty standards, raising expectations of beauty that are not obtainable by natural means [[1]Heyes C.J. Normalisation and the psychic life of cosmetic surgery.Aust Fem Stud. 2007; 22: 55-59Crossref Scopus (19) Google Scholar]. Popular procedures among adolescents in Western countries include nose reshaping, breast augmentation, and liposuction, as well as blepharoplasty or eyelid surgery in parts of Asia [2Plastic Surgery Procedural Statistics; Age Distribution: 13–19; 2010 American Society of Plastic Surgeons.http://www.plasticsurgery.org/Documents/news-resources/statistics/2010-statisticss/Patient-Ages/2010-teen-cosmetic-surgery-minally-invasive-13-19.pdfDate: 2010Google Scholar, 3Plastic Surgery Procedural Statistics; Age Distribution: 20–29; 2010 American Society of Plastic Surgeons.http://www.plasticsurgery.org/Documents/news-resources/statistics/2010-statisticss/Patient-Ages/2010-cosmetic-minimally-invasive-surgery-over-20-29.pdfGoogle Scholar, 4AAFPRSMembership Study, 2009 The American Academy of Facial Plastic and Reconstructive Surgery.http://www.aafprs.org/media/stats_polls/aafprsMedia2009.pdfGoogle Scholar, 5Wen H. Being good-looking is capital: Cosmetic surgery in China today.Asian Anthropol. 2009; 8: 90-104Google Scholar]. Researchers have noted an increase in media fascination with and reporting of celebrities who have elective procedures [[6]Sarwer D.B. Magee L. Crerand C.E. Cosmetic surgery and cosmetic medical treatments.in: Thompson J.K. Handbook of Eating Disorders and Obesity. Wiley, New York, NY2004Google Scholar]. Does the frequent attention focused on celebrities undergoing cosmetic surgery influence the behavior of adolescents who admire them? In this issue of the Journal of Adolescent Health, Maltby and Day demonstrate that teens who worship celebrities do not simply mimic their clothing and hairstyles, but also obtain elective cosmetic surgery more than those who do not worship celebrities. Cosmetic procedures have become pervasive, advertised in the mass media, and the subject of countless TV programs, such as Dr. 90210 (created in the United States but internationally known). The American Society of Aesthetic Plastic Surgery estimates that the number of children less than 18 years of age undergoing cosmetic surgery procedures by their members has ranged from 33,000 to 65,000 annually in the past 10 years, with nonsurgical cosmetic procedures ranging from 91,000 to 190,000 per year [[7]Cosmetic Surgery National Data Bank Statistics2000–2010 The American Society for Aesthetic Plastic Surgery.http://www.surgery.org/media/statisticsGoogle Scholar]. On a global scale, the possible reasons for increasing demand include higher disposable income, media portrayal, and reduced stigma [6Sarwer D.B. Magee L. Crerand C.E. Cosmetic surgery and cosmetic medical treatments.in: Thompson J.K. Handbook of Eating Disorders and Obesity. Wiley, New York, NY2004Google Scholar, 8Swami V. Arteche A. Chamorro-Premuzic T. et al.Looking good: Factors affecting the likelihood of having cosmetic surgery.Eur J Plast Surg. 2008; 30: 211-218Crossref Scopus (65) Google Scholar]. In addition to these factors, Maltby and Day find that adolescents' attitudes toward celebrities have a significant impact. Should the increase in elective cosmetic surgery among teens concern health professionals? Surgery to correct deformities such as cleft lip and palate has clear benefits. In contrast, procedures such as liposuction and breast augmentation among adolescents are much more controversial. There is no scientific evidence that surgery improves self-esteem or confidence in the long term, although it tends to increase satisfaction with the body part that was "fixed" [[9]Zuckerman D. Abraham A. Teenagers and cosmetic surgery: Focus on breast augmentation and liposuction.J Adolesc Health. 2008; 43: 318-324Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar]. Even without cosmetic procedures, satisfaction with appearance increases with age during adolescence [[10]Simis K.J. Hovius S.E. de Beaufort I.D. et al.After plastic surgery: Adolescent-reported appearance ratings and appearance-related burdens in patient and general population groups.Plast Reconstruct Surg. 2002; 109: 9-17Crossref PubMed Scopus (33) Google Scholar]. Cosmetic procedures can lead to medical complications, are extremely expensive, and often are not covered by insurance. There is the risk that initial procedures can lead to additional procedures either because of increased focus on achieving perfection or the need to correct an unsatisfactory procedure. Finally, the decision to undergo elective cosmetic surgery is associated with body dysmorphic disorder and low self-esteem [11Hass C.F. Champion A. Secor D. Motivating factors for seeing cosmetic surgery: A synthesis of the literature.Plast Surg Nurs. 2008; 28: 177-182Crossref PubMed Scopus (55) Google Scholar, 12Picavet V.A. Prokopakis E.P. Gabriëls L. et al.High prevalence of body dysmorphic disorder symptoms in patients seeking rhinoplasty.Plast Reconstr Surg. 2011; 128: 509-517Crossref PubMed Scopus (79) Google Scholar]. In the Maltby and Day study, 137 young adults in two cities in the United Kingdom completed questionnaires regarding attitudes toward celebrities whose body image they admired, previous experiences regarding cosmetic surgery, and a host of psychological and demographic measures, such as measures of body shape, self-esteem, life satisfaction, and self-rated attractiveness. The age range of the participants was 18–23 years. Eight months later, subjects were asked to report whether they had undergone elective cosmetic surgery [[13]Maltby J. Day L. Celebrity worship and incidence of elective cosmetic surgery: Evidence of a link among young adults.J Adolesc Health. 2011; 49: 483-489Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar]. The most frequent procedures reported by subjects were Botox, soft tissue fillers, breast augmentation, breast lift, laser skin resurfacing, and nose reshaping. After controlling for known predictors of cosmetic surgery, such as body-image preoccupation, self-esteem, sex, and previous cosmetic surgery, the researchers found that celebrity worship of an individual whose body was admired predicted the likelihood of cosmetic surgery. The practical consideration gained from the study is that providers should consider including a measure of celebrity worship when screening patients and discussing elective cosmetic procedures, in addition to discussing self-esteem, body image, and previous cosmetic surgery experience [[13]Maltby J. Day L. Celebrity worship and incidence of elective cosmetic surgery: Evidence of a link among young adults.J Adolesc Health. 2011; 49: 483-489Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar]. The study does have limitations. Notably, 23% of the 18–23-year-olds reported having cosmetic surgery at baseline, which rose to 31% after 8 months. These percentages are considerably higher than those in the general young adult population. The authors explain that these rates reflect an intentional bias within the study sample, and generalizations regarding the prevalence for all adolescents are not possible. However, such limitations do not affect the study's findings about celebrity worship and other variables significantly associated with cosmetic surgery. The results shed light on celebrity worship as a potential risk factor for undergoing elective cosmetic surgery in late adolescence and early adulthood. This has important implications for our celebrity-obsessed and media-saturated society. The findings support the need for standardized screening, including for body dysmorphic disorder and psychological problems, before cosmetic surgery. Effective screening could potentially improve the process by which decisions are made about whether adolescents should undergo procedures. In addition, the authors report that the incidence of celebrity worship decreases as one ages. Given normal development regarding celebrity worship, self-confidence, physical development, understanding of risk factors, and other maturation issues, health professionals would do well to recommend that teenagers wait before undergoing procedures such as breast augmentation and liposuction. In demonstrating the link between moderate celebrity worship and cosmetic surgery, the researchers address one aspect of a much larger, complicated issue. What areas associated with adolescent cosmetic surgery still need to be examined? Longitudinal research is needed to evaluate the appropriateness of performing cosmetic surgery on patients whose bodies and cognitive development have not reached maturity, in terms of physical and emotional outcomes. Future research is also needed on cosmetic surgery and differences related to race, age, socioeconomic status, and ethnicity, as well as the comparative effectiveness of cognitive behavioral therapy and other approaches for adolescents with negative perceptions of their bodies [[9]Zuckerman D. Abraham A. Teenagers and cosmetic surgery: Focus on breast augmentation and liposuction.J Adolesc Health. 2008; 43: 318-324Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar]. In addition to more research, there is certainly a need to develop guidelines involving screening and counseling by organizations that are actively involved in promoting the health and well-being of teenagers. Consent procedures for teens and their parents should be required to include a clear discussion of risks and benefits, photographs of adverse reactions, and a discussion of body image concerns and expectations of surgery [[9]Zuckerman D. Abraham A. Teenagers and cosmetic surgery: Focus on breast augmentation and liposuction.J Adolesc Health. 2008; 43: 318-324Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar]. Finally, young people should be encouraged to be more self-confident and accept their bodies as a whole, rather than conceptualizing themselves as a collection of body parts subject to surgical correction [[14]Calogero R. Pina A. Park L. et al.Objectification theory predicts college women's attitudes toward cosmetic surgery.Sex Roles. 2010; 63: 32-41Crossref Scopus (83) Google Scholar]. Data provided by Maltby and Day show there is much we need to do regarding cosmetic surgery and adolescents.
Referência(s)