Cosmetic surgery is increasingly popular around the world. Korea is gaining a reputation as a cosmetic surgery mecca. Based on statistics compiled by the International Society of Aesthetic Plastic Surgeons, South Korea had 649,938 cosmetic surgery procedures performed in 2011, representing a 22.4% increase from 2010 [1]. This number, divided by its 2011 population, reflects 13.5 people out of 1,000 individuals, according to a report from the Economist Online [2].

In line with the growing popularity of cosmetic surgery, many studies have been presented in Western countries. To explain the rise of the demand for cosmetic surgery, Rohrich [3] suggested improved safety and an increasing desire to appear youthful. Sarwer et al. [4] presented the medical advances and suggested that the influence of the mass media has attributed to this increase. Henderson-King and Henderson-King [5] examined the relationships between the perceptions about cosmetic surgery, an individual’s relationships, and the social environment. Crockett et al. [6] showed that exposure to the media plays a significant role in the perceptions that patients have about cosmetic surgery.

In recent research, psychological factors have been proposed to be important in the decision to undergo cosmetic surgery. Brown et al. [7] reported a strong correlation with an individual’s low selfrated attractiveness. von Soest et al. [8] also showed that considering cosmetic surgery is strongly related to self-esteem, social acceptance, and body image.

Despite significant studies in Western countries, very little research exits in South Korea that is related to the perceptions about cosmetic surgery. For this reason, Western studies have limited applications in East-Asian nations. The current study aimed to analyze the influences of demographics and psychological factors on perceptions about cosmetic surgery among professional women who have a greater level of expertise, and frequent interpersonal relations.

In 2010, the age distribution included 38.7% in their 20s, 34.1% in their 30s, and 27.2% in their 40s; 52.6% completed college, 37.8% graduated university, and 9.6% had a postgraduate degree. The majority were married (51.7%). With regard to monthly income, 20.1% earned 1.0 to 1.9 million won, 61% earned 2.0 to 2.9 million won, and 18.9% earned 3.0 to 3.9 million won; 40.9% had a past history of cosmetic surgery.

In 2014, the age distribution included 43% in their 20s, 31.8% in their 30s, and 25.2% in their 40s; 48.3% completed college, 44.5% graduated university, and 7.1% had a postgraduate degree. The majority were unmarried (54.8%). With regard to monthly income, 13.4% earned 1.0 to 1.9 million won, 65.9% earned 2.0 to 2.9 million won, and 20.7% earned 3.0 to 3.9 million won; 60.1% had a past history of cosmetic surgery (Table 1). Accordingly, 2010 and 2014 participants had similar demographic factors except monthly income.

Average self-esteem was statistically higher in 2010 than in 2014 (P<0.05). There were no statistically significant differences in average appearance interest and body image satisfaction between 2010 and 2014 (Table 2).

Average actual considerations about undergoing cosmetic surgery were statistically higher in 2010 than in 2014 (P<0.05) (Table 3).

Average actual considerations about undergoing cosmetic surgery were higher in those in their 30s who earned 2 to 2.9 million won per month in 2010 than in 2014 (P<0.05). There were no significant differences in education level, marital status, and previous experience with cosmetic surgery (Table 4).

Average actual considerations about undergoing cosmetic surgery were higher in those with high appearance interest, body image satisfaction, and self-esteem in 2014 than in 2010 (P<0.05) (Table 5).

The main purpose of this study was to examine recent changes in perception toward cosmetic surgery in professional women. With regard to perceptions about cosmetic surgery by age, those in their 30s showed more actual consideration in 2014 than in 2010. This shows a strong correlation with age. Fogel and King [11] found that as one’s age increases, one’s appearance become less attractive, leading to increased interest in cosmetic surgery. Frederick et al. [12] reported that older women may experience added pressure to undergo surgery because they feel they are competing with younger women for the attention of their current or potential romantic partner. Recent trends indicate that baby face fever is not limited to those in their 20s but has expanded to older ages, consistent with this result.

There were no statistically significant differences in perceptions about cosmetic surgery after considering the education level. This result is likely caused by the fact that appearance image management is greatly perceived in one’s social life, regardless of academic ability. There were also no statistically significant differences in examined perceptions about cosmetic surgery that depended on marriage.

Actual considerations of undergoing cosmetic surgery by women who had a monthly income of 2.0 to 2.9 million won increased in 2014 and are thought to be in the same context as increased consumer spending, and as away to seek improvements in living quality due to increasing income level; consequently, the cosmetic surgery market is being expanded. We also found that actual considerations of women who have experienced cosmetic surgery were increased in 2014, similar to the study by Swami et al. [13], in which cosmetic surgery experiences predict perceptions about cosmetic surgery. This shows continuously increasing efforts and perceptions about appearance management over time.

Those with high self-esteem showed higher actual considerations in 2014 than in 2010. This result conflicts with that of Ahn et al. [14], who found that people want cosmetic surgery to recover confidence, and that of Furnham and Levitas [15], who found that people with low self-esteem are likely to seek more cosmetic surgery. This result fits with that of Chen et al.’s study [16], indicating that those who seek more cosmetic surgery had higher self-esteem. This indicates that the recent atmosphere has been greatly reversed, as low self-esteem was previously a primary motivation for cosmetic surgery in the past.

Actual considerations in those with high appearance interest were statistically higher in 2014, consistent with the current trend showing that increasing demand is associated with increasing cosmetic surgeries.

Those with higher body satisfaction had higher actual consideration in 2014 than in 2010. This result conflicts with von Soest et al.’s study [8], which found that body image is one of the strongest motivations to undergo cosmetic surgery. This result also differs from the studies by Furnham and Levitas [15] and Chen et al. [16], who indicate that low body satisfaction is one of the most significant variables to influence the desire to undergo cosmetic surgery. This implies that the correlation between body satisfaction and cosmetic surgery is not as strong as before.

Our study was limited by several factors, including the small population size, same sex, and occupation. Additionally, the use of an invalidated questionnaire should not be over generalized. It would be more helpful to identify statistically significant factors if the number and ages of study subjects were increased and the questions were made more applicable to various occupational groups. To reflect the reality that expanding mass media, social networking site (SNS), and various advertisements greatly affect Korean society, follow-up studies about related independent factors are required.

The present study showed that those in their 30s, with a monthly income of 2.0 to 2.9 million won, and higher self-esteem, appearance interest, and body satisfaction were positively associated with perceptions about cosmetic surgery. Plastic surgeons should fully understand these changing perceptions to assess appropriate candidates and maximize with their results.