From Selfies to Surgery: Social Media Selfie Culture, Body Image Dissatisfaction, and Cosmetic Surgery Acceptance Among Young Adults in Pakistan

Abstract

The rapid growth of image-centered social media has intensified appearance-based comparison and contributed to the rise of selfie culture, particularly among young adults. Grounded in Social Comparison Theory, this study examined the relationship between social media engagement, body image dissatisfaction, psychological well-being, and attitudes toward cosmetic surgery in a South Asian context. A cross-sectional survey was conducted among 312 adults aged 18–35 years in Pakistan who had recently undergone aesthetic treatments or cosmetic procedures at plastic surgery centers. Data were collected using validated instruments, including the Body Shape Questionnaire-16, Rosenberg Self-Esteem Scale, Generalized Anxiety Disorder Scale, Patient Health Questionnaire, Acceptance of Cosmetic Surgery Scale, and Physical Appearance Comparison Scale-Revised. Ethical approval was obtained from Allama Iqbal Medical College, Lahore, and informed consent was secured from all participants. The mean age of participants was 24.6 ± 4.2 years; 63.5% were female and 36.5% were male. Females reported higher body image dissatisfaction and greater acceptance of cosmetic surgery than males. Social media engagement was positively associated with body dissatisfaction (r = .42, p < .001) and cosmetic surgery acceptance (r
= .36, p < .001). Selfie editing and filter use significantly predicted cosmetic surgery acceptance (β = .29, p < .01). Appearance-based social comparison was positively related to body dissatisfaction and cosmetic surgery acceptance, while body dissatisfaction partially mediated this relationship. Anxiety and depressive symptoms were positively associated with cosmetic surgery acceptance, whereas self-esteem was negatively associated. The findings highlight the need for psychological screening in cosmetic settings and digital literacy interventions that encourage healthier engagement with appearance-focused online content.