While there are no authoritative figures on the number of surgical or non-surgical procedures carried out in the UK or elsewhere, it is clear from the limited statistics available that the number of cosmetic procedures carried out has grown considerably in recent decades.(1) Although it remains the case that the majority of people undergoing procedures are women, the ratio of men to women having procedures has remained constant as the numbers choosing procedures has grown (men continuing to make up around a tenth of all those undertaking procedures).(2) Research exploring the factors that motivate people to undertake cosmetic procedures has highlighted both societal factors (such as the pressure to look young, media and celebrity influence, and seeking to confirm to cultural or social ideals),(3) and intrapersonal factors (such as body dissatisfaction and impact on self-esteem, teasing, and experience of family and friends).(4)
There is less research evidence exploring the reasons underpinning the radical growth in use of cosmetic procedures. Suggested explanations include increasing affordability; technological change making more procedures available; the pervasiveness of celebrity culture; the development of digitally manipulated photographs (leading to ever-more unrealistic representations of beauty); the rise in the use of social media (including the trend of postings ‘selfies’ online) and self-monitoring apps; and easier access to pornography depicting unrealistic images of what is normal or desirable.(5) In the context of the UK, these proposed explanations are also embedded in a society where body image is poor compared with other countries.(6)
The substantial increase in the number of cosmetic procedures performed has led to some commentators to argue that these procedures are becoming ‘normalised’: that is, that both cosmetic surgery, and invasive non-surgical procedures such as the use of injectable fillers and Botox, are increasingly perceived as routine, rather than exceptional, ways of changing one’s appearance.(7) This perception has, in turn, led to concerns that what is regarded as a desirable, or even acceptable, appearance may become increasingly narrow, increasing pressure on those whose appearance does not conform to these norms, and reinforcing stereotypes with respect to factors such as age, gender, sexuality, race, ethnicity, class, disability, and disfigurement.(8) It is also argued that the risks involved are increasingly likely to be overlooked or downplayed, if having a procedure is seen as something ‘normal’ or ‘routine’.(9) In contrast, others take the view that the increasing use of cosmetic procedures should be seen as positive and empowering: enabling people to access procedures to change aspects of their appearance that they do not like, or that cause them distress.(10)
4. What do you think are the main drivers generating the increasing demand for cosmetic procedures, both surgical and non-surgical?
5. Do you think it is becoming more routine to undertake cosmetic procedures? If so, in your view, does this raise any ethical issues?
6. How (if at all) does the increasing availability and use of cosmetic procedures affect social norms generally: for example with respect to assumptions about age, gender, race, disability etc (see above)?
7. Are some motivations for having a cosmetic procedure ‘better’ than others? If so, what are they, and who should judge?
8. Do you have any thoughts about, or experience of, the ways in which cosmetic procedures are advertised, marketed or promoted in the UK?
For footnotes 1-10, see the full call for evidence document.
How to submit your response
Please email your response to Kate Harvey at email@example.com, with ‘Cosmetic procedures’ in the subject line. If possible, responses should be in the form of a single Word document, with question numbers clearly indicated.
If you would prefer to respond by post, please send your submission to:
Nuffield Council on Bioethics
28 Bedford Square
London WC1B 3JS