Method
Procedures
We examined a quantitative observational cross-sectional study. We convenience sampling. The study population consisted of female users in Instagram from two different locations – Japan and the United States. The inclusion criteria for the participants were as follows: females from both countries between 18 and 35 years old. A sample size of 400 was calculated using a 95% CI and 0.05 degrees of freedom. The data was collected through Instagram during the day. The data was extracted for statistical analysis in SPSS.
The Instagram users were fully informed about the goals and purposes of the study and have participated voluntarily. They were able to refuse to share their images for this study at any given time. Informed consent was required at the beginning process of gathering images from the individual Instagram users.
We gathered the 400 most recent Instagram posts of images of individuals between January 20, 2020 and compared with the 2018 International Society of Aesthetic Plastic Surgery Report. The 2019 ISAPS ‘International Survey on Aesthetic/Cosmetic Surgery' statistics were examined by country, taking into account the underlying international base population according to the official United Nations population estimates. The number of surgeons was used to determine the number of procedures performed per surgeon.
The Instagram posts were coded for facial, upper body, and entire body of the photograph of oneself which were tagged with the hashtag #Happy and/or #Happiness. For the reliability analysis, we randomly selected 10% of the material. The analysis generally indicated reliable measurement. Krippendorff's a values were acceptable all (all values, a > .76).
Variables
Instagram Image Types.
The selfie types were coded as present when the Instagram post included an explicit reference of either face, upper body, or entire body. Images with hashtags of #happy and #happiness are considered only as a presentation of one's desire and satisfaction.
Emotions. The following emotional expressions were coded when they were visually or verbally present: Happiness/Happy (e.g., smiling faces, proud/confident faces and gesture).
Demographics. A total of 400 most recent Instagram image posts from both groups, 200 United States females and 200 Japan females, were downloaded. The age of the individual was coded. We coded whether the post included face, upper body, or full body of oneself.
Data Analysis. We calculated descriptive statistics with percentage values and 95% confidence intervals based on bootstrapping techniques. The percentage values are significantly different when the confidence interval does not overlap. The confidence interval lower and upper limits are reported after the percentage value.
RESULTS
This research findings indicate that the use of social media may be correlated with amplified acceptance of particular types of cosmetic surgery. These findings can assist three areas as follows; 1) the future social psychologists discussion regarding awareness of self-worth through social media, 2) future patient-physician dialogue regarding cosmetic surgery perceptions, which vary by social media or photo editing application use, and 3) the attitude towards the types of cosmetic procedure. Overall social media is a significant driver of cosmetic interventions. It is important to recognize the latent societal benefits of social media, such as the dissemination of knowledge, discussion of new ideas, and community building, however, it is also important to recognize the human nature to engage in comparison, which encourages negative influences on self- worth by comparing oneself to others (e.g. superior).
The highest demand countries for surgical cosmetic procedures are the United States and Brazil followed by Japan. There was an explicit reference to the preferences of physical appearance where people want to improve, which are significantly different by culture. Within the search of hashtags, such as #happy and #happiness, physical appearance was a strong predictor of one's happiness.
In the United States, the distribution among types of Instagram images (e.g. Face/Head, Upper Body, and Entire Body) are almost equally desired to post. The types of cosmetic procedures are also desired evenly on their body. Americans considered the breast and overall body image more important than face area alone. Their beauty interest is in the overall frame rather than a particular area of a body even within face/head area (see Table 1).
In contrast, Japanese strongly desired to post face and head photography of themselves and nearly did not care to display their upper body nor entire body in the Instagram post. The same trend was observed in the surgical cosmetic procedure preferences where Japanese have drastically high aspiration to have facial/head area of cosmetic procedures than other areas. In particular, they preferred eyelid surgery the most, which demonstrates their specific face area of interest instead of the whole face and/or its structure. In fact, Japanese preferred to have the facial cosmetic procedure 18 times more likely desire than having a cosmetic procedure on their other body areas. The breast was the least interested area to improve their body image. They were 19 times more likely to post facial specific images than images including their upper or entire body.
Table 1. Instagram Image post and Surgical Cosmetic procedure comparison.
The physical attractiveness was the dominant image types in Instagram under the hashtags of #happy and #happiness as proved from our previous study. The appearance of physically attractive body images on Instagram is a strong predictor to young adult themselves being happy on social media.
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