Cultural commentators argue that we live amid an “age of narcissism,” where narcissistic self-absorption and perfectionistic striving encourage interest in cosmetic surgery.1 Case studies and media reports also suggest that narcissism (vanity, exhibitionism, superiority, and entitlement) and perfectionism (ceaselessly demanding perfection of oneself) foster interest in cosmetic surgery.2 Such observations, although provocative, have yet to be subjected to empirical scrutiny.
To address this shortcoming, we recruited 305 undergraduate women (mean ± SD age, 19.48 ± 3.26 years) who completed reliable and valid self-report questionnaire measures of narcissism,3 perfectionism,4 and interest in cosmetic surgery.5 Our study was approved by an institutional ethics committee, and participants provided informed consent in writing. A moderated multiple regression analysis predicting interest in cosmetic surgery explained a moderate amount of variance (R 2 = 0.05, p < 0.05) and indicated that narcissism (β = 0.07, p > 0.05) and perfectionism (β = 0.10, p > 0.05) were unrelated to interest in cosmetic surgery. However, narcissism interacted with perfectionism (β = 0.14, p < 0.05) such that interest in cosmetic surgery was greatest among individuals with high levels of both narcissism and perfectionism (Fig. 1).
Our results lend credence to observations implicating narcissism and perfectionism in cosmetic surgery1,2 and refine this literature by suggesting that a synergistic relation between narcissism and perfectionism may underlie and motivate interest in cosmetic surgery. Narcissistic perfectionists (individuals characterized by extreme levels of both narcissism and perfectionism) may strive to perfect their bodies through cosmetic surgery in an effort to garner attention, demonstrate superiority, or augment a grandiose but unstable sense of self.3,4
Although not all cosmetic surgery patients are narcissistically pursuing bodily perfection, important implications for cosmetic surgeons nevertheless arise from our results. Narcissistic perfectionists may be particularly challenging and potentially hostile patients. Indeed, a vain, entitled, and grandiose patient demanding a perfect (and therefore unrealistic) outcome may be nearly impossible to satisfy—even if an objectively successful and aesthetically pleasing surgical outcome is obtained. Pairing surgical procedures with psychological interventions may assist narcissistic perfectionists in overcoming barriers to a satisfying surgical experience.
Simon Sherry, Ph.D.
Paul Hewitt, Ph.D.
Gordon Flett, Ph.D.
Dayna Sherry, Ph.D.
Department of Psychology
Halifax, Nova Scotia, Canada
1. Twenge J, Campbell W. The Narcissism Epidemic.
New York: Free Press; 2009.
2. Goldwyn R. The Patient and the Plastic Surgeon.
Boston: Little, Brown; 1991.
3. Raskin R, Terry H. A principle-components analysis of the Narcissistic Personality Inventory and further evidence of its construct validity. J Pers Soc Psychol.
4. Hewitt P, Flett GL. Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. J Pers Soc Psychol.
5. Sherry S, Hewitt P, Lee-Baggley D, Flett G, Besser A. Perfectionism and thoughts about having cosmetic surgery performed. J Appl Biobehav Res.
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