From Nose Job to a Better Job: A Scoping Review of Facial Aesthetics, Attractiveness Bias, and Outcomes in the Workplace

Abstract Background Facial appearance strongly influences professional and social outcomes, with individuals perceived as more attractive often receiving increased job opportunities—a phenomenon known as “attractiveness bias.” As facial plastic surgery becomes increasingly common, its potential impact on workplace dynamics and ethics warrants evaluation. Objectives To synthesize current evidence examining the relationship between facial aesthetic surgery, attractiveness bias, psychosocial outcomes, and professional trajectories. Methods A comprehensive search of the MEDLINE database via PubMed, Cochrane Library, SCOPUS, and PsycINFO was conducted (inception-September 10, 2025) according to PRISMA-ScR guidelines. Controlled vocabulary (MeSH) and free-text terms related to facial aesthetic surgery, career outcomes, and attractiveness bias were combined. Studies were included if they examined surgical facial aesthetic or reconstructive procedures and assessed self-perception, attractiveness bias, professional or socioeconomic outcomes, or appearance-related psychological distress. Results Sixty-one studies met inclusion criteria and were synthesized qualitatively into three conceptual domains. Across studies, facial aesthetic surgery consistently enhanced both self-perception and external evaluations. Postoperative images were rated as more attractive, trustworthy, competent, and intelligent than preoperative images. Patients reported improved self-esteem and social functioning, with several studies identifying career advancement as a key motivator. In contrast, individuals with facial trauma, congenital malformations, or features diverging from cultural beauty norms reported discrimination and lower levels of overall satisfaction. Rates of body dysmorphic disorder among surgical candidates ranged from 2.5% to 32%. Conclusions Facial aesthetic surgery may influence professional outcomes by modifying self-confidence and how others perceive competence. Plastic surgeons should recognize workplace-related motivations during consultation and incorporate ethical counseling to ensure informed decision-making. Further longitudinal research is needed to clarify whether cosmetic enhancement leads to tangible increased earnings.