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Self-esteem among young women undergoing facial plastic surgery in China

The JAMA Network Journals

A study of young women in China undergoing cosmetic surgery on their eyelids and noses suggests feelings of self-esteem and self-efficacy (confidence in one's abilities) were lower before surgery but increased in the months after surgery, according to an article published by JAMA Facial Plastic Surgery.

The number of patients undergoing facial cosmetic surgery in China has increased markedly in the past decade. As more young women seek these procedures more research is investigating the psychosocial profile of these patients.

Jincai Fan, M.D., of the Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, and coauthors examined the association of patient psychological traits, the decision to undergo cosmetic surgery and the effectiveness of surgery on the psychological conditions of these young women.

The study enrolled 161 cosmetic surgery patients (CSPs), 355 general population controls (GPCs) and 268 facial appearance raters (FARs). Patient data were obtained from questionnaires preoperatively and six months after surgery. Front-view facial images also were taken and show to FARs.

The authors report self-esteem and self-efficacy scores were lower preoperatively in young women compared with women in the general population who had not visited a plastic surgeon, but those scores increased to nearly normal levels six months after surgery.

While there was no significant difference between cosmetic surgery patients and women from the general population in the objective assessment of facial appearance by the FARs, the average scores for cosmetic surgery patients' self-assessments were lower for the eyes, nose and overall facial appearance.

The authors note a number of limitations to the study, which include generalizability.

"Self-esteem and self-efficacy mediate the negative effects of self-assessment on the decision of young women to undergo facial cosmetic surgery. The impairment of self-esteem and self-efficacy may indicate the need for preoperative psychological intervention," the study concludes.


(JAMA Facial Plast Surg. Published October 15, 2015. doi:10.1001/jamafacial.2015.1381. Available pre-embargo to the media at

Editor's Note: This work was supported by a grant from the Doctorial Innovation Fund of Peking Union Medical College. Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Media Advisory: To contact corresponding author Jincai Fan, M.D., email

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