The mediating role of social appearance anxiety in the relationship between instagram social comparison and cosmetic surgery acceptance: Implications for workplace wellbeing

Background Visually oriented social media use has increased social comparison processes and appearance-related concerns, potentially affecting psychosocial well-being, job burnout, and attitudes toward cosmetic surgery in professional settings. Objective This study examined the effects of Instagram-based social comparison, social media addiction, and social appearance anxiety on cosmetic surgery acceptance, with a focus on testing the mediating role of social appearance anxiety and investigating differences across employment groups. Methods This cross-sectional, descriptive study included 772 participants. Data were gathered using standardized instruments, and subgroup analyses were performed to compare employed and unemployed participants. Results Female participants scored significantly higher on all scales (p < 0.05). Significant predictors of cosmetic surgery acceptance included social appearance anxiety ( β =0.255), age ( β =0.145), previous procedures ( β =-0.274), and family history ( β =-0.119). Employed participants demonstrated significantly higher levels of upward social comparison (p < 0.001) and greater cosmetic surgery acceptance (p < 0.001) than unemployed participants. Mediation analysis confirmed that upward social comparison indirectly influenced cosmetic surgery acceptance through social appearance anxiety (Indirect Effect=1.13, 95% BootCI [0.77, 1.53]). Conclusions Social appearance anxiety is a key mechanism linking digital comparison to cosmetic surgery acceptance. The heightened cosmetic surgery acceptance among employed individuals highlights the need for workplace wellness and Employee Assistance Programs to address occupational lookism, appearance-related anxiety, and return-to-work rehabilitation concerns.