Beauty unboxed: Unveiling the 'why' behind plastic and cosmetic surgery in young adults

 Corresponding author: Kerem Kemal Soylemez Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution License 4.0. Beauty unboxed: Unveiling the ‘why’ behind plastic and cosmetic surgery in young adults Emma Sofia Ruffo, Ana María Carretero-Resino, Kerem Kemal Soylemez * and Joanne Lusher School of Psychology, Regent’s University London, Inner Circle, Regent’s Park, London, NW1 4NS, United Kingdom. World Journal of Advanced Research and Reviews, 2025, 26(03), 2519-2530 Publication history: Received on 17 May 2025; revised on 23 June 2025; accepted on 26 June 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.26.3.2461 Abstract The present qualitative study delves into the interplay of beauty ideals, cosmetic and plastic surgeries, and the sociocultural influences of the digital age. Through the use of semi-structured interviews with 10 women who have undergone aesthetic procedures, the study explores the psychological effects, and the challenges posed by societal norms and social media. Drawing upon phenomenological interpretivism, the research captures participants’ lived experiences and illustrating the profound impact of cosmetic and/or plastic procedures on self-esteem, body image, and confidence through a thematic analysis of the data. Findings reveal that individuals’ struggle with conforming to the euro-centric beauty norms propagated on social media and the unattainable standards set through the use of editing apps and filters. Nonetheless, the participants highlighted the beneficial psychological effects of plastic surgery, and the consequent self-esteem boost they experienced following a cosmetic procedure. These women also emphasised the importance of celebrating and recognising cultural diversity on social platforms in relation to the Western beauty norms perpetuated. Moreover, the study critically examined the responsible use of cosmetic and plastic surgery, the importance of informed decision-making, and appropriate guidance from healthcare professionals. Keywords: Plastic surgery; Cosmetic surgery; Qualitative; Thematic analysis 1. Introduction The use of body modification as a tool of self-expression has drastically evolved over the centuries across different cultures and societies. While in the past these practices may have not been solely associated with enhancing beauty, in today’s world, body modification practices in the form of plastic or cosmetic surgery can be adopted to enhance one’s natural beauty. Indeed, many cultures throughout Asia, America, Africa, and Oceania utilised body modification practices to differentiate individuals and rank their status, or sometimes as a form of torture, punishment, and revenge. In others, as a consensual spiritual procedure, or for medical purposes [1]. In the past, body modification practices have been documented in Southeast Asia, where individuals would blacken [2] or file [3] their teeth for aesthetic purposes. Tattoos and piercings were also common procedures as means of spiritual protection and status markers [4]. In Europe, tattoos were common among sailors and members of the working class around the beginning of the 20th century [5]. Later on, tattoos were utilised to determine affiliations to specific groups such as gangs, bikers, or prisoners [6]. More recently, tattoos and piercings have become a common practice among individuals, regardless of group connections or social status. The term plastic surgery was coined approximately two hundred years ago as a result of the publication of Karl Ferdinand von Graefe’s ‘Rhinoplastik’, which referred to nasal reconstructive procedures [7]. This subsequently led surgeon Eduard Zeis in 1838 to labelling reconstructive surgeries as ‘Plastische Chirurgie’ [8]. Beyond medicalised interventions, the practice of physical reconstructions can be traced back to the 15th century in Europe, and up to two millennia ago in India. The art of bodily reconstructions started gaining popularity in the United Kingdom at the World Journal of Advanced Research and Reviews, 2025, 26(03), 2519-2530 2520 beginning of the 19th century, when army soldiers returning from the frontline after experiencing imprisonment or torture for extended periods of time were subjected to surgical reconstructions. In 1818, after years of research, renowned English surgeon J. C. Carpue put into practice his procedures on a soldier whose nose was destroyed after prolonged use of mercury as medication. The surgery was a success, and Carpue’s method gained popularity among British surgeons, who named the procedure ‘Indian Rhinoplasty’ [9]. Throughout the century, incremental medical advancements were made by surgeons in Europe, from the development of skin grafts for burn victims [10], to the improved facial reconstructive surgeries for war veterans [11]. It was not until WWI that plastic surgery was established as a specialty in its own right by Harold Gillies and Kelsey Fry, who published their work in a book entitled ‘The Plastic Surgery of the Face’ [11]. By the beginning of WWII, Gillies had trained a new generation of doctors who were adopting his procedures. Alongside his colleagues he founded the national basis for plastic surgery as a specialist in the UK [9]. The significance of their work began spreading all over the world, leading doctors from different continents to visit the UK to learn more about their newly developed techniques which included advances in burn treatments, metabolic disorders, immunology, and other practices originating from the medical hub formed in the aftermath of the rise of plastic surgery [9]. Differently from plastic surgery, which initially intended for reconstructing missing or destroyed body parts, cosmetic surgery began its popularity with the same intent it holds nowadays: tackling individual’s perceived imperfections (without apparent medical benefits or purposes). American surgeon John Roe [12] wrote the first paper on cosmetic surgery in 1891, entitled ‘The Deformity Termed Pug Nose, and Its Correction by a Simple Operation’. Interestingly, Dr Roe notes that the majority of individuals asking for the aforementioned procedure were men and not women, contrary from today’s prevalence among women [9]. Following the commercialisation of such procedures, and more specifically their pervasiveness on social media platforms with the advent of the internet, cosmetic surgery has increasingly gained popularity among young female adults [13]. A US study conducted on millennials reported a 50% increase in minimally invasive procedures from 2015 to 2020 [14]. Additionally, research suggests a possible relationship between social media usage and propensity to cosmetic procedures in young adults. Hermans et al. [15] found that participants who used highly visual social media platforms (e.g., TikTok and Instagram) were more likely to consider cosmetic surgery. Although an inclination was identified, this does not necessarily translate into actual behaviour, i.e. it cannot be assumed that social media usage directly influences young adults to undergo cosmetic surgical procedures. On another note, notwithstanding the focus of the current study, it must be highlighted that many body modifying interventions are carried out among trans populations within medicalised and informal settings. The latter tends to include high-risk practices such as injecting engine oil or taking unprescribed drugs both in Western countries and other contexts with historic recognition of non-medicalised identities for gender variance or third gender individuals [16]. In relation to the medical body modifications, it is worth echoing Bartnett et al’s [17] recognition of the pioneering work of plastic surgeons in gender-affirming interventions. These practitioners dealt with the complexities of reconstructive and/or cosmetic interventions for individuals presenting with a diagnosis of gender dysphoria [18] and other trans and gender variant individuals without a diagnosis who seek authentic biopsychosocial ways of expressing their identity [16]. While it is unclear what shifted the gendered demand for cosmetic and plastic surgery predominantly from men to women, it could be argued that once the efficacy and safety procedures had been confirmed, a more commercialised use of these surgeries spread among civilians and therefore women became a perfect consumer target. Theoretically speaking, there are multiple possible reasons why women and men are drawn to cosmetic and plastic surgery. From a traditional evolutionary perspective, it could be argued that women seek out these procedures to enhance the physical features associated with fertility within prevailing heterosexist aesthetics. For example, the commonly known ‘hourglass figure’ is said to be alluring due to the increased waist-to-hip ratio (WHR), a potential indicator of a woman’s fecundity and therefore an attractive feature according to men’s standards [19]. As reported by Grammer et al. [20], human beings and other animal species do not differ in remarkable ways when it comes to sexual selection. That is, the criteria human beings have to choose sexual partners are not so different from those of other animal species. Nonetheless, it could be argued that among other organisms and species, it is often the male that has to be more aesthetically alluring to maximise mating opportunities. Sexual selection can be defined as a state of competition that arises in animals in search of a potential mate [21]. This theory argues that just like animals, humans have developed a sense of what is attractive through evolution. Just like male peacocks developed colourful tails to attract female attention, human beings nowadays place emphasis on what they think the other sex perceives as attractive. Men might flaunt their money and material possessions to signal status and boast their symbolic power [22], while women might wear makeup to enhance their beauty or enquire about plastic surgery to change physical traits deemed unappealing by normative societal standards [23]. Other researchers [24] have theorised that attractiveness can be determined by analysing individuals’ facial features. The main factors affecting one’s perception of facial attractiveness are identified as averageness, symmetry, and sexual dimorphism. In line with the Aristotelian golden ratio, the higher the averageness, World Journal of Advanced Research and Reviews, 2025, 26(03), 2519-2530 2521 the symmetry, and the femininity of features, the more likely an individual is to be perceived as attractive [25]. Other factors influencing attractiveness established through research are skin appearance and eye size. Vernon et al. [26] conducted a study on impressions of social traits based on facial inferences. Using factor analysis and correlation, they found that bigger eyes are significantly correlated with youthfulness and attractiveness, while dominance is significantly correlated with stereotypically masculine facial traits. This posits that unconscious assumptions based on physical features are constantly made, suggesting that evolution might play a role in determining what individuals find subjectively attractive. However, there are less simplistic and more nuanced assumptions tied to the expansion in cosmetic surgeries, and this brings back a discussion on reassignment surgery for some trans individuals. Current UK NHS waiting times for transition related surgeries exceed three years, leading trans people to struggle with mental health issues as a result of the wait [27]. While this may suggest that there is more to gender identity and expression than what evolutionary perspectives argue, some queer researchers have highlighted the ways in which normative gender aesthetics are internalised and embodied by some trans people, leading them to perpetuating transnormative ideas that resonate with patriarchal values of beauty and attractiveness [16]. This unfairly constructs trans individuals (particularly trans women who often are the target of vitriolic and dehumanising debates) as agents responsible for the perpetuation of traditionally sexist ideas around gender, while denying the authenticity behind their gender expression, bodily presentation and sartorial choices. Moreover, the idea that women would change their bodies with the sole objective of satisfying men is reductionist and also eliminates agency and authenticity. As reported by Wright (p.724) [28] “our culture places a higher value on the attractive appearance of the woman than that of the man […] that the woman, deprived of many sources of gratification available to men, has learned to use and value her body to please herself and others”. Women have been shown to battle with their body image because they face more social pressure early on in life to meet unrealistic beauty standards than men. This also ties to the different gendered socialisation and identity constructions given to boys and girls [29, 30]. For example, a study by Pingitore et al. [31] investigated differences in body dissatisfaction in college men and women and found that women showed significantly greater weight dissatisfaction than men at most weight categories. This is because in current Western culture, femininity and masculinity traditionally place value on different social aspects linked to biological essentialisms that see women taught to nurture and enhance their physical attributes, while men are raised with the notion that power equates dominance, rendering their external beauty a secondary concern [32]. Consequently, women tend to be more dissatisfied with their bodies since they find it harder to meet normative societal standards, hence they are more likely to use plastic and cosmetic surgery to adhere by the status quo [33]. In recent years, an increase in men requesting plastic and cosmetic procedures has been registered. Data gathered by the American Society of Plastic Surgeons [34] shows that 69% of hair transplants in that year were performed on men, as well as 42% of otoplasties (ear surgeries), and 56% of calf augmentation surgeries. The most popular procedure among men was nose reshaping, with 65,121 male individuals getting a rhinoplasty. However, women are still the main category of individuals requesting cosmetic and plastic interventions. They dominate the statistics for buttock and breast augmentations, with 21,492 procedures for the former and 193,073 procedures for the latter, as of 2020. Still, the most common procedure for women is rhinoplasty, adding up to a total of 287,434 procedures out of 352,555 (82%). It is worth framing some of these statistics within subgroups, as some of the interventions among male populations can be traced to gay male subgroups in [35] as issues around the (gay) male gaze position them in a sexualised, objectified level similar to that occupied by women, with the added layers of stereotyping and historic marginalisation. It is much less common for heterosexual men than it is for women to openly talk about their relationship with plastic and cosmetic surgery, hence the shortage of literature investigating the male experience with cosmetic procedures. Holliday and Cairnie [36] conducted one of the few available studies on the experiences of men with aesthetic surgeries. In this qualitative research, the focus was on four interviews with men who had undergone a number of procedures, ranging from otoplasties, to hair transplants, and scar revision procedures following a traumatic injury. They found that few of the interviewed participants would support the idea that their decision to get surgeries was a response to social pressure, but rather as a tool for future benefits in terms of enhanced positions in different spheres of life such as work, relationships, or sexuality. In fact, while created with the purpose of reconstructing men’s body parts after returning from the war, the practice of plastic surgery for male aesthetic purposes is not discussed in much detail. Sinno et al. [37] reports that men are being introduced to cosmetic surgery procedures through their spouses, some of which getting treatments and procedures together. A psychoanalytical theory put forward by Kurtz [38] argues that women have more awareness of their body than (heterosexual) men, and therefore they have a more articulated notion of what they want or not want from cosmetic procedures. Following this logic, men’s increased request of cosmetic procedures might suggest a surgical search of aesthetic identity [39]. World Journal of Advanced Research and Reviews, 2025, 26(03), 2519-2530 2522 Objectification theory was put forward by Fredrickson and Roberts [40] with the aim of addressing the underemphasised view that there is more to the perception of the body than mere biology. Since bodies exist in a sociocultural context as much as they do in an anatomical one, it is logical to assume that social constructs and discourse affect how individuals view their own bodies. This theoretical framework places the (heterosexual) female body in a sociocultural context with the purpose of highlighting the mental health risks associated with sexual objectification for women. The common denominator in all forms of sexual objectification is the notion of being treated as a body (or parts of one), with the sole function of being of use to (or possessed by) others. Sexualisation can occur in many forms; some can be violent and obvious (e.g., sexual violence) [41], while others can be more subtle, although just as impactful (e.g., sexual evaluation) [42]. The predominant way of being evaluated sexually is through the gaze of others i.e., a visual inspection of the female body [39]. Studies show that women are observed more often than men in public settings [43], to the point that the English language has developed specific words like ‘ogling’ and ‘leering at’ to describe a woman being stared at for prolonged periods of time [44]. This is not to say that all men sexually objectify women, but rather that society normalises the constant examination of the female body and frames the public space as a masculine one where women and non-normative bodies are constantly interrogated and examined. It is therefore unsurprising that women are the main users of plastic and cosmetic surgery to correct what they see as imperfections, knowing that their physical attractiveness is constantly monitored by the gaze of others. The advent of social media has provided a more powerful and pervasive medium through which individuals can now compare and judge their physical appearance in relation to others. With over 800 million monthly active users, Instagram is one of the most used social networking sites in the world [45]. Differently from other platforms such as X (formerly Twitter) that are more text-based, Instagram is mainly based on picture-sharing. Anyone can like anyone’s public pictures at any time, as well as leave comments sharing their thoughts. While these types of platforms allow individuals to connect and share life experiences, it is not exempt from risk and pernicious effects. In fact, research shows that social media can greatly impact a person’s identity development and their gender constructions, especially among young women [46]. On one hand, the connective nature of social media allows women to network with other like-minded individuals and create their own idea of what femininity is. On the other, there is a greater risk for younger women to be exploited for sexual purposes on platforms such as Snapchat, potentially wrongfully shaping their notion of feminine sexuality [47] and enticing them to be more precious. The Tripartite Influence Model proposed by Thompson et al. [48] suggests that the main sociocultural factor’s affecting one’s beauty ideals are peers, parents, and the media. This is supported by other studies [49] that found that British teenage girls frequently receive comments on Instagram regarding their physical attractiveness, from strangers and peers alike. Additionally, increased social media usage (and the influence of algorithms and biased content) has been linked to body image concerns and the development of eating disorders [50]. These findings suggest that social media can have adverse consequences on women’s mental health and their self-image, leading to the potential development of disordered eating habits and other associated comorbidities. Walker et al. [51] conducted a study aiming to investigate whether exposure to images of women with plastic and cosmetic enhancements on social media affected participants’ desire for cosmetic procedures. They found a marginally significant effect on their participants and also found that participants who were less satisfied with their bodies and used social media the most were more likely to desire cosmetic and plastic surgeries. Their research also found that the relationship between cosmetic procedures and social media usage was not mediated by body dissatisfaction, suggesting that social media use was a stronger predictor for desire of cosmetic surgery than body dissatisfaction. Beyond the studies and ideas explored, a legitimate consideration on the ethical practices of providers of cosmetic surgeries and interventions is paramount, as they profit economically and professionally from the potential undermining of individual’s self-confidence and issues around body image. While most professional providers are bound by ethical guidelines [52, 53, 54], the current consumerist context may often see these blurred, particularly among practitioners who are not medically trained and do their interventions in informal or unregulated settings. 1.1. The Current Study The aim of this study was to investigate the reasons behind cosmetic and plastic surgery in young women through a qualitative approach, using thematic analysis and the development of themes generated from data collected by interviewing participants. The study sought to understand the motivations and factors that lead young adults to desire cosmetic and plastic procedures, considering both evolutionary perspectives and the influence of social and cultural factors, including the impact of social media. The overarching research question in the present study was “What are the motivational factors that lead young adults to go under cosmetic and plastic procedures?” World Journal of Advanced Research and Reviews, 2025, 26(03), 2519-2530 2523 2. Material and methods 2.1. Methodological Approach Thematic analysis was employed to gather data due to the subjective nature of the research, hence allowing for a deeper understanding of participants’ experiences. Unlike quantitative methods, which focus on numerical data and statistical analysis, a qualitative approach allows for a more nuanced understanding of the underlying reasons that drive young adults to seek plastic and cosmetic procedures. Additionally, by embracing an inductive approach, the study remains open to unexpected findings, which is particularly valuable to the current study since there is a lack of thematic analysis investigating the motives for plastic and cosmetic surgery in young adults. Thematic analysis can be defined as a qualitative method of research used for identifying, analysing, and reporting patterns within data [55]. The main benefit of this type of qualitative research is that it allows for a great deal of flexibility, ergo allowing the researcher to investigate the topic of interest from numerous perspectives. However, a general structure should still be maintained in order to preserve clarity and reliability of results. The establishment of clear criteria for identifying themes and patterns will aid in maintaining rigor and credibility in the qualitative analysis process. 2.2. Epistemological Positioning and Philosophical Underpinnings Utilising Laverty’s [56] approach to phenomenological interpretivism, the present study delves into the lives of participants and their journey towards surgical interventions. Moreover, the research draws inspiration from Heidegger’s [57] framework, hence prioritising an existential understanding of the sociocultural context in which interviewed individuals exist. Simplistically, this entails embracing the narratives shared by participants as valuable sources of self-knowledge and recognising them as active agents who can produce insightful accounts of their own lived experiences. In practical terms, the present study adopted an inductive approach to unearth the pivotal themes within the data. Concurrently, core concepts of Interpretative Phenomenological Analysis (IPA) were adopted as a theoretical lens to gain deeper insights into the various perspectives of participants’ experiences, especially for those relating to their physical transformations. The phenomenological notions of embodiment (i.e., the subjective experience of one’s own physicality) and intersubjectivity (i.e., the interconnection with others) were found to resonate with participants’ accounts [58]. It is also worth mentioning that this phenomenologically informed thematic analysis finds its roots within the context of prior psychological qualitative work, such that of Spiers and Riley [59]. 2.3. Sampling Strategy and Participant Recruitment Participants were selected following criteria of inclusion and exclusion established before the recruiting process. Therefore, participants were included if aged between 18 and 30 years old, so that the experiences and motives shared excluded aging reasons. Moreover, all participants had to have at least one cosmetic and/or plastic procedure done. Finally, participants currently diagnosed with any mental health conditions were excluded to ensure ethical adherence. A total of 10 women were recruited through social media, in the form of Instagram stories or Facebook posts on groups dedicated to plastic surgery. Women’s ages ranged from 20 to 27, and 7 out of 10 women were Caucasian, 1 woman was Afro-Italian, and 2 women were of Asian descent. Evidently, a limitation of this study is the lack of male participants recruited, due to their unwillingness to openly share their experiences. If participants were not recruited through social media, additional women were selected using snowball sampling. Snowball sampling involves participants referring other potential participants from their own social networks [60]. This referral approach can be particularly useful when investigating sensitive topics, as participants may feel more comfortable participating when referred from someone they trust, which is applicable to the present study. 2.4. Materials and Procedures Semi-structured interviews were conducted asking questions designed to elicit a comprehensive range of responses that would allow for a broad understanding of the topic. Participants were asked about the specific procedures they had undergone; they were prompted to elaborate on their personal reasons to get plastic and cosmetic procedures, and their views on the notion of body image as a general concept as well as on a personal level. Additionally, participants were asked about their social media usage and which platforms they used most frequently. The research process began by gaining ethical approval, followed by the recruiting process. Participants were recruited through the use of social media. Adverts were posted on Instagram and Facebook stories to attract attention. The second step was to post the recruiting advert on Facebook groups dedicated to plastic and cosmetic surgery. These groups likely consisted of individuals with specific interest in the subject matter, making them potential valid contributors to the study. However, the process encountered some limitations as some of the groups were private and members were not willing to share about their experience with plastic and cosmetic procedures. This limitation may have restricted World Journal of Advanced Research and Reviews, 2025, 26(03), 2519-2530 2524 the potential participant pool, but efforts were made to engage participants from various sources to overcome this challenge. The majority of participants were obtained from Instagram, and the rest through snowball sampling. This social media platform is particularly useful for the current study due to its pervasive usage by young adults. Additionally, the chosen sampling technique helps to enhance participant diversity and gather a more comprehensive range of experiences. All participants could choose whether they preferred to attend the interview online or in person depending on their availability and residence. Once a date and time for the interviews was established, the researcher provided all participants with consent forms to sign. Participants were also reminded that they could withdraw from the study at any time if they felt uncomfortable or unable to continue during the interview. Finally, participants were reminded that no renumeration would be given for their voluntary participation. 3. Results and discussion After analysing the dataset using TA, two key themes with two subthemes emerged from participants’ narratives. Table 1 presents all emergent themes, which are discussed throughout the findings section. The themes were: Motivations to reconstruct confidence through surgery and The dual struggle of being desired and racial identity. Table 1 Themes and Sub-themes Themes Sub-themes Motivations to reconstruct confidence through surgery From self-doubt to self-love Hashtag beauty: social media made me do it The dual struggle of being desired and racial identity I want you to want me Navigating racial identity 3.1. Motivations to reconstruct confidence through surgery 3.1.1. From self-doubt to self-love One of the main themes encountered was the beneficial effects experienced by participants following their cosmetic or plastic procedures. Overall, participants reported experiencing positive feelings after their procedures, and all participants claimed they did not regret having plastic or cosmetic surgery. This might be due to the positive effect on their self-esteem leading them to regain confidence, which has lasted throughout the years and is still ever-present. Some narratives revealed a fundamental stigma that surrounds these procedures, that is the lack of authenticity behind the obtained beauty. It could be argued that it is because of this stigma that individuals still struggle or are hesitant to share their experiences with plastic surgery, fearing their newly found self-confidence to be undervalued because of it. Some participants’ experiences indicated that the state of uncomfortableness (potentially induced by others) in relation to their body disappeared following the cosmetic procedure, supporting the beneficial effect of plastic surgery to increase one’s confidence levels [61]. Participants reaffirmed the notion that plastic surgery is not always perceived as valuable as natural beauty is, which emphasises their associated fears and doubts It was clear from participants narratives that they struggled with numerous conflicting emotions after their procedures. The sense of betrayal reported in their narratives is in line with the societal notion that one must achieve an introspective acceptance of their physical attributes without the use of artificial instruments, otherwise it lacks in value, and it feels like the ‘easy way out’ [32]. Whether this preconception is societal, parental, or peer induced is unclear. However, participants’ willingness to undergo their chosen surgeries despite experiencing contradicting emotions suggests that their desire to feel comfortable in their own body precedes any other influences they might encounter. The results obtained from this qualitative investigation support those of the existing literature that highlights the positive psychological effects of plastic and cosmetic surgery in young adults. For example, Di Mattei et al. [62] compared patients’ psychological distress with their body image pre and post operations. They found significant improvements of their psychological distress linked to their body image in all participants except those that had diagnosed body image disorders. This is further supported by recent research highlighting the positive psychological effects of cosmetic procedures in young adults, especially for individuals with physical abnormalities, hence improving their quality of life [63]. This supports the current study’s finding that almost all participants experienced immediate satisfaction with the results of their operations and none of participants regretted their choice of getting plastic and/or cosmetic procedures. World Journal of Advanced Research and Reviews, 2025, 26(03), 2519-2530 2525 Nonetheless, it might be worth considering the influence of social desirability bias as a potential limitation when interpreting the findings due to the self-reporting nature of this study [41]. Additionally, participants reported experiencing a significant boost in self-esteem and confidence following their procedures. This aligns with the evolutionary perspective that physical enhancements can lead to increased attractiveness, hence affecting one’s physical perception and that of others. This can also be linked with the theory of attractiveness privilege presented by Langlois et al. [64]. 3.1.2. Hashtag beauty: social media made me do it A second emergent theme following interviews with participants was the influence of social media in setting beauty standards. Specifically, participants reported social media as being one of the main influences they experience in deciding what is considered attractive and what is not. When asked about their social media usage and the content creators they follow on different platforms, all participants reported using at least one form of social media every day. It is apparent that for some participants, the physical appearance of the influencers they follow online is more important than the content produced by the individuals. This supports the notion that social media is a crucial influence in setting beauty standards for other females [65]. Participants’ narratives highlighted that social media may also be beneficial in shaping a positive perception of body image, indicating that it is possible to foster a healthy discourse regarding young adult’s bodies. It would be beneficial to investigate what differentiates a positive representation of beauty from a negative one on social platforms. Indeed, when asked about the way body image is portrayed on social media, most participants’ opinions were negative in nature. The influence of social media on participants’ perception of beauty standards and body image emerged as a theme during interviews. Participants expressed negative emotions when discussing of the representation of physical appearance on social media. Specifically, of the unrealistic beauty standards that highly edited images place on young women. This aligns with the ‘Other Gaze Effect’, where societal pressures and external influences such as social media contribute to the desire for cosmetic and plastic procedures. The emergence of social media has magnified the scrutiny young individuals face regarding their physical appearance. While initially intended to connect people from all over the world, social platforms have now been established as the benchmark to determine popularity status and set unattainable beauty standards. The rise of filters and editing apps has blurred the lines between reality and illusion, distorting individuals’ perceptions of what is attainable. The narratives participants shared underscore the psychological toll that constant exposure to these images can create, leading individuals to compare themselves to the carefully curated online personas of influencers and celebrities. 3.2. The dual struggle of being desired and racial identity 3.2.1. I want you to want me While the need to be appreciated and wanted is a common experience that precedes the emergence of social media, it could be argued that the comparative nature of social platforms enhances the pre-existing desire to be liked. This may lead young individuals into making rushed decisions with long-lasting effects, or to develop disordered eating habits to meet the thin beauty standard. It is evident from the held interviews that the main concern participants reported with the way body image is portrayed on social media is the exaggerated use of filters and editing apps to enhance one’s looks and minimise flaws. In addition to this, another main worry that emerges is the lack of honesty in the use of these edits, which participants claim can cause feelings of inadequacy and discontent with one’s physical appearance. Other critiques regard the unrealistic standards these edited pictures place on young women. Following the narratives of participants’, it is possible to hypothesise that a potential motive young women have to get plastic, and cosmetic surgery is to meet the expectations of what a female body looks like on social media [66]. This is also accompanied by the need to meet the assumptions other individuals have developed based on the way the female body is shown on such platforms. With regards to this, participants’ main concern is the way this misrepresentation will shape future women’s beauty standards, as well as men’s. Not only that, but also the potential feeling of needing to fit in following unrealistic beauty standards with the aim of being liked by others. The preoccupation of unhealthy beauty standards affecting younger women is also shared by other participants, which is echoed by existing literature [67]. Although participants’ worries are mainly focused on the impact social media might have on women’s perception of body image, it should be noted that none of the interviewed participants regretted their choice of getting plastic surgery. Whether this is due to a limited sample size or because all their procedures were successful is unclear. However, the concerns participants raised were not limited to the overuse of plastic surgery, but also peer pressure, bullying, and the potential development of psychopathologies such as eating disorders. World Journal of Advanced Research and Reviews, 2025, 26(03), 2519-2530 2526 3.2.2. Navigating racial identity Some participants experienced different forms of pressure from social media to meet the impossible standards of perfection posed by highly edited pictures. Some participants identified that because the most followed categories of social media content are Western dominated, the global differences in ethnicities are not taken into account, and neither are the Eurocentric aesthetics that may be pervasive in postcolonial contexts and individuals whose backgrounds are found within a postcolonial setting [68]. Consequently, leading to a Western view of how beauty should look like that completely rejects or ignores different ethnic physical features. This is further supported by other shared experiences of participants who struggled with their racial identity while growing up. Participants experienced issues related to beauty standards and they expressed feelings of loneliness and isolation while being in a country where majority of people were of a different ethnicity. It is evident from participants’ voices that struggles related to racial identity and Western beauty standards are influenced by other sociocultural factors. This finding supports the Tripartite Influence Model proposed by Thompson et al. [48], which identifies peers, parents, and media as influences affecting one’s own bodily perception. It could be argued that environmental and cultural changes can alter and shape one’s perception of beauty ideals aligning with a particular canon, which is often white Western, and Eurocentric. Participants’ narratives highlight the malleability of perceptions, indicating that social contexts are crucial in determining what we consider acceptable. While degree of influence cannot be precisely identified, it is apparent from the reported interview that pre-existing insecurities and racial identity dilemmas also play a role in influencing the desire for cosmetic and plastic procedures. The present study revealed elements of racial identity and consequent struggles related to the unattainable euro-centric beauty standards perpetrated by social media. Participants shared experiences of feeling pressured to conform to such beauty ideals in multiple occasions, and they highlighted the somewhat limited representation of diverse beauty standards on social media. This finding underscores the importance of acknowledging and celebrating the diverse cultures and ethnicities in discussions surrounding ideal beauty standards and cosmetic procedures. A concern surrounding the mass-marketing of contemporary white beauty ideals includes an increase in individuals utilising skin-whitening products or bleach in an attempt to lighten skin colour [69]. This practice is further commercialised through social apps like Facebook. For example, a partnership formed between the tech giant, and Vaseline used to allow users to lighten their skin tone on their profile pictures as a promotive tool to sell their new product, ‘Healthy White: Skin Lightening Lotion’ [69]. This supports the current study’s finding that social media content can have a significant impact on individuals’ beauty standards. Moreover, perpetuating the Western ideals of attractiveness and some racist supremacist ideas around beauty being the monopoly of whiteness [70], hence leading individuals who do not conform to feel pressured to do so. While skin bleaching has been a common practice which often stems from deeply ingrained colourism [71], its prevalence has been rapidly increasing over the past years, especially in formerly colonised African countries [72]. It could be argued that the new view of the body as a ‘work in progress’ rather than a ‘given’ leads individuals to satisfy their own aesthetic preferences as they wish [69]. While not all procedures undergone by the interviewed participants are directly related to their ethnic phenotypes, it is evident from their testimony that a struggle with their racial identity occurred prior to the choice of undergoing cosmetic or plastic procedures. This reaffirms the internal dilemma experienced by young individuals as a potential contributor to undergoing plastic and cosmetic surgeries. However, it is worth mentioning that experiences relating to beauty standards can be nuanced and vary among individuals. In fact, participants also noted that social media allowed them to feel empowered and validated when consuming inclusive content that challenged conventional beauty norms. A recommendation for future studies would be to investigate further the potential reasons for the limited cultural representation. Specifically, whether it is due to the algorithm favouring specific types of content, or because there is a lack of content creators representing different cultures. 4. Conclusion This study comprehensively investigated the motivations behind cosmetic and plastic procedures among young women. The findings highlight the complex relationship between sociocultural, identity-related, and psychological factors that shape an individuals’ desire for cosmetic procedures. The psychological benefits of plastic surgery have been unequivocally affirmed by the findings from this study. The experienced increase in self-esteem and comfortableness with their bodies post operations align with evolutionary theories of attractiveness and the existing literature on the benefits of aesthetic procedures. While a correlational relationship between the psychological well-being of participants and such procedures can be inferred, further research employing experimental designs could assist literature to investigate their causational association. The implications of these findings are not limited to individual experiences. World Journal of Advanced Research and Reviews, 2025, 26(03), 2519-2530 2527 Healthcare professionals, policymakers, and educators can benefit from this new data and the gained insights on the motivations for aesthetic procedures in young women. For future research, it would be useful to investigate the longterm effects of plastic and cosmetic surgery, taking into account diverse cultural backgrounds and different social contexts. Additionally, investigating the influence of familial, peer, and social pressure in shaping individuals’ perception of beauty would provide a broad understanding of this phenomenon. Compliance with ethical standards Acknowledgments Authors would like to thank those who took part in this study. Disclosure of conflict of interest The authors declare that there is no conflict of interest. Statement of ethical approval Ethical approval was obtained from the Research Ethics Committee at Regent’s University London. Statement of informed consent Informed consent was obtained from all individual participants included in the study. References [1] Henley D, Porath N. Body modification in East Asia: History and debates. Asian Studies Review. 2021 Apr 3;45(2):198-216. [2] Zumbroich TJ. The ethnobotany of teeth blackening in Southeast Asia. Ethnobotany Research and Applications. 2009 Nov 16;7:381-98 [3] Jones A. Dental transfigurements in Borneo. British Dental Journal. 2001 Jul;191(2):98-102. [4] Reid A. Southeast Asia in the age of commerce, 1450-1680. New Haven: Yale University Press; 1988. [5] Sanders CR. Customising the body : the art and culture of tattooing the body. Philadelphia: Temple University Press; 1989. [6] DeMello M. Bodies of inscription: A cultural history of the modern tattoo community. Duke University Press; 2000. [7] Macionis V. History of plastic surgery: Art, philosophy, and rhinoplasty. Journal of Plastic, Reconstructive and Aesthetic Surgery. 2018 Jul 1;71(7):1086-92. [8] Zeis E. Handbuch der plastischen Chirurgie: mit vielen Holzschnitten und zwei Kupfertafeln. De Gruyter, Incorporated; 1838. [9] Bennett JP. Aspects of the history of plastic surgery since the 16th century. Journal of the Royal Society of Medicine. 1983 Feb;76(2):152-6. [10] Carpue JC. An account of two successful operations for restoring a lost nose. Plastic and Reconstructive Surgery. 1969 Aug 1;44(2):175-82. [11] Gillies HD. Plastic Surgery of the Face Based on Selected Cases of War Injuries of the Face Including Burns with Original Illustrations. 1920. [12] Roe JO. The deformity termed “pug nose” and its correction, by a simple operation. Plastic and Reconstructive Surgery. 1970 Jan 1;45(1):78-81. [13] Walker CE, Krumhuber EG, Dayan S, Furnham A. Effects of social media use on desire for cosmetic surgery among young women. Current psychology. 2021 Jul;40:3355-64. [14] Pearlman RL, Wilkerson AH, Cobb EK, Morrissette S, Lawson FG, Mockbee CS, Humphries LS, Ward KH, Nahar VK. Factors associated with likelihood to undergo cosmetic surgical procedures among young adults in the United States: a narrative review. Clinical, cosmetic and investigational dermatology. 2022 May 12:859-77.