Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Adolescent Desire for Cosmetic Surgery: Associations with Bullying and Psychological Functioning

Lee, Kirsty M.Sc.; Guy, Alexa M.Res.; Dale, Jeremy Ph.D., M.B.B.S., F.R.C.G.P.; Wolke, Dieter Ph.D., Dr. rer. nat. h.c.

Plastic and Reconstructive Surgery: May 2017 - Volume 139 - Issue 5 - p 1109-1118
doi: 10.1097/PRS.0000000000003252
Cosmetic: Special Topics
Press Release
Video Discussion

Background: Adolescent bullying may be a key driver of interest in cosmetic surgery. This study examined the extent of such interest and whether any effect was sex-specific, and examined psychological functioning as a potential mechanism through which bullying involvement may lead to a wish for cosmetic surgery.

Methods: A two-stage design was used. In the first stage, 2782 adolescents (aged 11 to 16 years) were screened for bullying involvement using self-reports and peer nominations. In the second stage, 752 adolescents who were bullies, victims, bully-victims, or uninvolved in bullying reported their desire for cosmetic surgery. Psychological functioning was constructed as a composite of self-esteem and emotional problems (assessed at stage 1) and body-esteem scores (assessed at stage 2).

Results: Adolescents involved in bullying in any role were significantly more interested in cosmetic surgery than uninvolved adolescents. Desire for cosmetic surgery was greatest in adolescents who were bullied (victims and bully-victims) and girls. Desire for cosmetic surgery was highest in girls, but sex did not interact with bullying role. Being victimized by peers resulted in poor psychological functioning, which increased desire for cosmetic surgery. In contrast, desire for cosmetic surgery in bullies was not related to psychological functioning, which was in the normal range.

Conclusions: Bullying victimization is related to poor psychological functioning, and both are related to a greater desire for cosmetic surgery in adolescents. Cosmetic surgeons should screen candidates for psychological vulnerability and may want to include a short screening questionnaire for a history of peer victimization.

Coventry, United Kingdom

From the Department of Psychology and the Warwick Medical School, University of Warwick.

Received for publication August 1, 2016; accepted October 24, 2016.

Disclosure:The authors have no financial interest to declare in relation to the content of this article. Kirsty Lee and Alexa Guy were supported to undertake this research by a departmental fellowship.

Supplemental digital content is available for this article. Direct URL citations appear in the text; simply type the URL address into any Web browser to access this content. Clickable links to the material are provided in the HTML text of this article on the Journal’s website (

A Video Discussion by David Sarwer, Ph.D., accompanies this article. Go to and click on “Video Discussions” in the “Digital Media” tab to watch.

Dieter Wolke, Ph.D., Dr. rer. nat. h.c., Department of Psychology, University of Warwick, Coventry CV4 7AL, United Kingdom,

Copyright © 2017 by the American Society of Plastic Surgeons