Psychological and Body Image Correlates of the use of Facial Non-Surgical Cosmetic Medical Procedures in middle-Aged and Older Women, and the Role of Attentional Processes

Odette Norton

doi:10.25907/00658

The demand for cosmetic medical procedures has risen dramatically over recent decades. According to the American Society of Plastic Surgeons (ASPS), 17.5 million surgical and non-surgical cosmetic procedures were performed in the United States alone in 2017. The highest consumers of cosmetic procedures were women aged between 40 and 54 years, followed by those aged 55 years and over. Women in these demographics were also the highest consumers of minimally invasive non-surgical cosmetic procedures designed to rejuvenate the ageing face. Although this pattern of demand suggests that ageing-related appearance concerns may motivate use of these procedures, little is known about body image related to ageing in women, especially facial ageing concerns in these demographics. Also, little is known about the potential role of psychological factors such as self-esteem and mood, and cognitive factors such as selective attention to ageing-related information, which may underlie use of these procedures. The aim of this research project was to address these gaps in the literature, by using a mixed-methods approach comprising three studies. The first study was a qualitative exploration of the thoughts, feelings, and experiences of women aged 40 years and over with regard to facial ageing, and their attitudes towards cosmetic medical procedures. Women (N = 29) were recruited from the general community and university to take part in individual or small group semi-structured interviews. Key themes and subthemes identified reflected women's perceptions and feelings about their ageing faces, the personal and social meaning and ramifications of looking older, and their attitudes towards cosmetic medical procedures. Themes also highlighted the importance of psychological factors of self-esteem, mood, and body image, which helped inform the selection of psychological measures in the second and third studies, as well as the generation of word stimuli for an experimental task in the last study. Study 2 (N = 298), via an online survey, focused on psychologically characterising middle-aged and older women who use non-surgical cosmetic procedures, compared to those who had not used procedures. Findings suggested that self-esteem, mood, overall face satisfaction, and perceived age did not differ markedly, when comparing women who had used non-surgical cosmetic procedures and non-users with no interest in these procedures. However, women who had used non-surgical procedures were more invested in their appearance, and were also more satisfied with their appearance overall, although they were less satisfied with their faces in regard to ageing, when compared to non-users with no interest in procedures. Also non-users with high interest in non-surgical cosmetic procedures had lower self-esteem, and higher depression and anxiety when compared to non-users with no interest in procedures, as well as women who had previously used non-surgical cosmetic procedures. Study 3 (N = 63) then examined whether women who had used non-surgical cosmetic procedures demonstrated an attentional bias for ageing-related information, when compared to non-users of these procedures. This involved the use of a dot-probe task which employed word stimuli derived from transcripts and themes in Study 1. Word stimuli included general ageing words, negative and positive face words, negative and positive emotion words, and cosmetic procedures words. However, findings suggested selective attention to ageing-related words did not differ as a function of use or non-use of non-surgical cosmetic procedures, word type, body satisfaction, or level of interest in future use of non-surgical cosmetic procedures. In sum, this programme of research developed a current understanding of psychological and information processing characteristics of women who use facial non-surgical cosmetic procedures, and thus extended upon the literature relating to women and ageing, body image, the cosmetic procedure literature, as well as attentional bias research. It is anticipated these findings will provide a useful framework for future investigations into this under-researched domain.

Psychological and Body Image Correlates of the use of Facial Non-Surgical Cosmetic Medical Procedures in middle-Aged and Older Women, and the Role of Attentional Processes

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