Self-reported Patient Motivations for Seeking Cosmetic Procedures

Importance: Despite the growing popularity of cosmetic procedures, the sociocultural and quality-of-life factors that motivate patients to undergo such procedures are not well understood. Objective: To estimate the relative importance of factors that motivate patients to seek minimally invasive cosmetic procedures. Design, Setting, and Participants: This prospective, multicenter observational study was performed at 2 academic and 11 private dermatology practice sites that represented all US geographic regions. Adult patients presenting for cosmetic consultation or treatment from December 4, 2016, through August 9, 2017, were eligible for participation. Exposures: Participants completed a survey instrument based on a recently developed subjective framework of motivations and a demographic questionnaire. Main Outcomes and Measures: Primary outcomes were the self-reported most common motivations in each quality-of-life category. Secondary outcomes were other frequently reported motivations and those associated with specific procedures. Results: Of 529 eligible patients, 511 agreed to participate, were enrolled, and completed the survey. Typical respondents were female (440 86.1%), 45 years or older (286 56.0%), white (386 75.5%), and college educated (469 91.8%) and had previously received at least 2 cosmetic procedures (270 52.8%). Apart from motivations pertaining to aesthetic appearance, including the desire for beautiful skin and a youthful, attractive appearance, motives related to physical health, such as preventing worsening of condition or symptoms (253 of 475 53.3%), and psychosocial well-being, such as the desire to feel happier and more confident or improve total quality of life (314 of 467 67.2%), treat oneself or celebrate (284 of 463 61.3%), and look good professionally (261 of 476 54.8%) were commonly reported. Motivations related to cost and convenience were rated as less important (68 of 483 14.1%). Most motivations were internally generated, designed to please the patients and not others, with patients making the decision to undergo cosmetic procedures themselves and spouses seldom being influential. Patients younger than 45 years were more likely to undertake procedures to prevent aging (54 of 212 25.5% vs 42 of 286 14.7% among patients ≥45 years; P < .001). Patients seeking certain procedures, such as body contouring (19 of 22 86.4%), acne scar treatment (36 of 42 85.7%), and tattoo removal (8 of 11 72.7%), were more likely to report psychological and emotional motivations. Conclusions and Relevance: This initial prospective, multicenter study comprehensively assessed why patients seek minimally invasive cosmetic procedures. Common reasons included emotional, psychological, and practical motivations in addition to the desire to enhance physical appearance. Differences relative to patient age and procedures sought may need further exploration.