The Role of Self-Esteem and Body Image in Shaping Cosmetic Surgery Acceptance

Background: In recent decades, cosmetic surgery has emerged as a significant and complex field within the broader scope of plastic surgery, contributing to its ongoing development and growth. Cosmetic surgery involves procedures aimed at enhancing, restoring, or altering a person’s physical appearance, which may include modifications to any area of the body. Objective: This study aimed to explore the relationship between self-esteem, body appreciation, and the acceptance of cosmetic surgery among individuals in Bosnia and Herzegovina. Methods: A cross-sectional survey was conducted between August and November 2024, involving 165 participants (84.8% female) aged 15 to 63 years. Participants completed self-administered questionnaires, including the Acceptance of Cosmetic Surgery Scale (ACSS), Body Appreciation Scale (BAS), and Rosenberg Self-Esteem Scale (RSES). Data were analyzed using descriptive statistics, correlation analysis, and ANOVA. Results: The findings revealed that self-esteem was generally high (mean = 24.05/30), body appreciation was moderate (mean = 51.87/65), and the acceptance of cosmetic surgery was moderate (mean = 56.48/105). Significant predictors of cosmetic surgery acceptance included prior experience with cosmetic surgery, with individuals who had previously undergone procedures displaying higher acceptance. There were moderate positive correlations between self-esteem and body appreciation, but no significant correlation was found between self-esteem or body appreciation and cosmetic surgery acceptance. Socio-demographic factors such as age, gender, and marital status had minimal impact on cosmetic surgery acceptance. Conclusion: The study suggests that while participants in Bosnia and Herzegovina show moderate acceptance of cosmetic surgery, factors such as prior experience with cosmetic surgery, body image, and personal desire for self-improvement may influence attitudes more strongly than self-esteem alone. These findings offer valuable insights into the psychological and cultural factors shaping cosmetic surgery attitudes in this population.