An experimental study examining the impact of exposure to cosmetic surgery advertising on women's body image and intentions to undergo cosmetic surgery

Objective: There have been calls from health professional organisations and advocacy groups to regulate and ban cosmetic surgery advertising due to concerns about increasing uptake of elective cosmetic surgical procedures that are often accompanied by substantial financial, medical and psychological costs. To date, the impact of cosmetic surgery advertisements on body image and intentions to undergo cosmetic surgery has not been examined experimentally. Method: A community sample of British women (N=193) were randomly assigned to view one of four conditions: cosmetic surgery advertisements with models, cosmetic surgery advertisements without models, beauty product advertisements with models, and beauty advertisements without models. Participants completed validated measures of state body dissatisfaction, intentions to undergo cosmetic surgery, internalisation of cultural beauty ideals and appearance comparisons. Results: Women exposed to advertisements featuring models reported significantly greater body dissatisfaction post exposure compared to women exposed to advertisements without models. No differences in body dissatisfaction emerged post-exposure between cosmetic surgery and beauty product advertisements with, and without, models. There were also no differences between conditions on intentions to undergo cosmetic surgery. Internalisation of cultural beauty ideals and appearance comparison tendency did not moderate these effects. Conclusion: Compared to exposure to beauty product advertising, exposure to cosmetic surgery advertising did not result in increased state body dissatisfaction and intentions to undergo cosmetic surgery. The effect of cumulative, longer-term exposure to cosmetic surgery advertising and the inclusion of models in advertisements should be examined in order to guide policy makers towards the most effective strategies involving this form of advertising

The routine psychological screening of cosmetic surgery patients

In order to improve outcomes, the process of patient selection within the cosmetic industry has received considerable attention from surgeons, psychologists and policy makers. Indeed, as increasing numbers of people are seeking cosmetic procedures it is crucial to ensure that patients are appropriately assessed for their suitability for surgery. Pre-operative screening to identify patients at risk of poor post-operative outcomes is now considered a crucial part of the surgeon’s role in providing appropriate care and treatment. In recognition of the importance of patient selection, we have developed a brief, user-friendly screening tool designed for routine use with cosmetic surgery patients. The tool has been designed to identify psychological factors which are likely to increase the risk of a poor psychological outcome. The tool should be used in addition to a thorough pre-operative consultation and as part of a pathway which includes onward referral where necessary

Consumer opinion on social policy approaches to promoting positive body image: Airbrushed media images and disclaimer labels

© The Author(s) 2015. Disclaimer labels on airbrushed media images have generated political attention and advocacy as a social policy approach to promoting positive body image. Experimental research suggests that labelling is ineffective and consumers' viewpoints have been overlooked. A mixed-method study explored British consumers' (N = 1555, aged 11-78 years) opinions on body image and social policy approaches. Thematic analysis indicated scepticism about the effectiveness of labelling images. Quantitatively, adults, although not adolescents, reported that labelling was unlikely to improve body image. Appearance diversity in media and reorienting social norms from appearance to function and health were perceived as effective strategies. Social policy and research implications are discussed

Assessing the effectiveness of interventions to support patient decision making about breast reconstruction: A systematic review

© 2018 Elsevier Ltd Background: Decision making about breast reconstruction (BR) following a diagnosis of breast cancer, Ductal Carcinoma in Situ (DCIS), or to reduce future breast cancer risk, is difficult and complex. This paper systematically reviews interventions aiming to support patients facing the option of BR, and assesses their effectiveness in improving a range of patient outcomes. Methods: Ten databases were searched for articles published up to October 2017 that evaluated interventions to support patient decision making about BR within controlled trials. All included studies were assessed for methodological quality. Descriptive analyses of patient outcomes within included studies were performed. Results: The search yielded 3291 articles. Eight studies met the inclusion criteria resulting in the evaluation of seven distinct interventions (n = 1212). Six studies were assessed to be of weak methodological quality, with one of moderate and one of strong quality. Three out of five interventions demonstrated a reduction in decisional conflict (ds = 0.26–0.69) and two out of three interventions resulted in reductions in decisional regret (ds = 0.27–3.69) at various time points. Treatment choice was altered in two of five studies. There were no changes in patient-reported anxiety levels, whilst the impact on depression was mixed. In all studies which reported on it, improvements in patient satisfaction and involvement in decision making were found. Conclusions: Few interventions are currently available. Whilst some findings are encouraging, improvements on patient outcomes are mixed. Further research should focus on the development and evaluation of effective interventions

Facilitating shared decision-making with breast augmentation patients: Acceptability of the PEGASUS intervention

© 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons Background PEGASUS is an intervention to facilitate shared decision-making by helping prospective patients consider their expectations of surgery, so that surgeons have a clear understanding of their individual goals. To date, shared decision-making interventions within aesthetic surgery are lacking. The present mixed methods study therefore explored the acceptability of implementing PEGASUS into routine private practice with breast augmentation patients and aesthetic providers. Method Seventeen women presenting for breast augmentation surgery from three practices received the PEGASUS intervention pre-operatively and completed a process evaluation post-operatively. Semi-structured interviews exploring 3 aesthetic providers’ experiences of using PEGASUS were subjected to a thematic analysis, whilst a content analysis was conducted on the 77 goals identified by patients. Results The majority of patients reported that the PEGASUS intervention was relevant, helpful and useful, and they felt comfortable during it. Qualitatively, patients and aesthetic providers found that PEGASUS enabled them to reflect on and discuss about their expectations from surgery. Aesthetic providers discussed some of the issues and barriers associated with implementing PEGASUS in routine private practice, factors that must be considered prior to further evaluation. Conclusion This study provides preliminary support for the acceptability of PEGASUS to breast augmentation patients and to aesthetic providers working in the private sector

Body Image in Primary Schools: A pilot evaluation of a primary school intervention program designed by teachers to improve children's body satisfaction

© 2016 Body Image in the Primary School (Hutchinson & Calland, 2011) is a body image curriculum that is widely available but has not yet been evaluated. This study evaluates a set of 6 of the 49 available lessons from this curriculum. Seventy-four girls and 70 boys aged 9–10 were recruited from four primary schools in the UK. Schools were randomly allocated into the intervention condition, where students received 6hours of body image lessons, or to lessons as normal. Body esteem was significantly higher among girls in the intervention group, compared to the control group, immediately post intervention, and at 3-month follow-up. Moreover, girls with lowest levels of body esteem at baseline reported the largest gains. Internalization was significantly lower among boys in the control group compared to the intervention group at 3-month follow-up. The pattern of results among the control group raises interesting issues for intervention evaluation

Exploring the experiences and psychosocial support needs of informal carers of men with breast cancer: A qualitative study

Purpose: The provision of practical and emotional support for men who have been diagnosed with breast cancer in the UK falls primarily on their partners, close family members or friends. However, informal carers’ experiences are omitted from the research literature. Therefore, the present study aimed to explore the care-giving experiences of informal carers (ICs) of men with breast cancer in the UK and identify psychosocial support needs and preferences. Methods: Semi-structured interviews, conducted on the telephone or via online video calls, explored ICs’ experiences of providing support, the psychosocial issues they faced and the impact of the illness on themselves and their relationship with the patient. They were also asked about any support previously offered to them, in addition to their support preferences. Twelve ICs participated (11 females, 1 male), and 9 were spouses. Interview transcripts were analysed with reflexive thematic analysis using NVIVO software. Results: Four key themes were identified: “The impact of caring”, “Lack of awareness”, “Isolated and alone” and “Making a difference”. Conclusions: The physical, emotional, financial and social impact of providing emotional and practical care and support for a man diagnosed with breast cancer can be considerable. ICs may experience significant levels of distress and often feel isolated. Greater awareness and more research is needed to better understand the psychosocial impact and support needs for ICs of men with breast cancer. There is an evident necessity to address their information needs and offer sources of support throughout the cancer journey

The nature and importance of women's goals for immediate and delayed breast reconstruction

Objectives: Increasingly, women undergo breast reconstruction (BR) surgery to restore health-related and psychosocial quality of life after mastectomy. Most research focuses on BR outcomes rather than women's pre-surgical expectations of, and goals for, immediate (IBR) or delayed (DBR) procedures, yet such information could support women's decision-making. This study aimed to investigate women's BR goals, whether they differed according surgery timing (IBR or DBR), and the importance women placed on them. Methods: Seventy-six women considering DBR (n = 50) or IBR (n = 26) at a UK hospital were encouraged to clarify their BR goals and rate the importance of achieving each one. Content analysis categorised and counted the frequency of the goals they reported. Results: Fifteen goal categories (7 surgical, e.g. scarring; 8 psychosocial/lifestyle, e.g. feeling feminine) were identified. Many (e.g. scarring, intimacy) were reported by a similar percentage of women in each surgical group, however, differences were identified (e.g. breast sensation was not mentioned by women considering IBR). Women reported more psychosocial (n = 206) than surgical goals (n = 160). Further, an independent t-tests revealed that women in both groups placed significantly more importance on the psychosocial (M = 9.4) than surgical goals (M = 8.5). Conclusions: This study highlights the variety of goals women have for BR, the importance they attach to them, and differences and similarities between those seeking IBR and DBR. Future research should consider whether BR goals are met, how goal achievement influences satisfaction with outcome over time and how best to incorporate goals into pre-surgical treatment decision-making

A cognitive dissonance body image intervention ‘Free Being Me’ delivered by Guide leaders to adolescent Girl Guides in India: A pilot and acceptability trial

This pilot study assessed the acceptability and pre-post intervention effects of a cognitive dissonance-based body image intervention, Free Being Me, delivered by Guide leaders to adolescent girls in India. Girls aged 11-14 years (Mage = 12.6, N = 117), who were members of the national scouting and guiding association of India, received the intervention across five weekly 1-hour group sessions. The primary outcome (body esteem) and secondary outcomes (self-esteem, internalisation of appearance ideals, negative and positive affect, and life disengagement) were measured pre-intervention and immediately post-intervention. The intervention was acceptable. Adolescent girls reported high levels of comfort (89%), enjoyment (90%), and perceived importance (92%) with suggestions for improvement including more interactive activities. Facilitator adherence and competence delivering Free Being Me was rated good. Significant within-groups pre-post intervention improvements in body esteem (Cohen’s d = 0.28) and reductions in internalisation of appearance ideals (Cohen’s d = 0.49) were identified. No changes to self-esteem, negative or positive affect, or life disengagement were observed. This study suggests that Free Being Me is acceptable for community-based delivery and Guide leader format with promising pre-post intervention effects. Going forward, a randomised controlled trial is necessary to make confident interpretations on the effectiveness of Free Being Me