Trends and demographic characteristics of Saudi cosmetic surgery patients ========================================================================= * Sami E. Alharethy ## Abstract **Objectives:** To present the demographic characteristics of Saudi patients undergoing cosmetic procedures. **Methods:** This prospective study survey was conducted in 3 private cosmetic surgery centers in different regions of Saudi Arabia (Riyadh and Jeddah) between January and August 2016. Validated questionnaire with modification was used and the following patient’s information were provided: age group, height and weight, marital status, number of children, age of the patient’s spouse, educational level, monthly income, name of the cosmetic procedure, names of any previous cosmetic procedures and their reason for cosmetic procedure. **Results:** The present study revealed that a typical Saudi cosmetic surgery patients are university graduates, married (46.8%), employed (68.3%), and middle aged 20-40 years of age (70%), with a fairly high typical monthly income. **Conclusion:** There is a possible positive correlation between gender and undergoing cosmetic procedure. Laser hair removal, botox, liposuction, filler, and scar revision are common among females, while rhinoplasty is a common procedure among males. The number of females who undergo cosmetic surgery in Saudi Arabia has increased dramatically over the last few years. This demonstrates that cosmetic surgery is becoming a new trend related to beauty ideas, especially for women and to some extent for men. However, increasing awareness of cosmetic procedures is wreaking havoc on women in ways that far exceed the bounds of monthly income, educational status or age. The trends are changing and the age of women undergoing cosmetic surgery procedures is decreasing. This new level of spending on cosmetic alteration is taking a terrible toll in all areas of women’s lives, from economic well-being to health and interpersonal relationships. Women are spending large amounts of money on cosmetic surgical procedures, and the numbers are increasing. In another study, young people aged 19-34 years old had the highest approval rating for surgical procedures.1 ## Methods The present study was performed on Saudi patients seeking cosmetic surgery at 3 cosmetic surgery private hospitals in different regions of Saudi Arabia (Riyadh and Jeddah) between January and August 2016. A previously validated published questionnaire with modification (Appendix 1) was used and included the following patient information: age group, height and weight, marital status, number of children, age of the patient’s spouse, educational level, monthly income, name of the cosmetic procedure, names of any previous cosmetic procedures, and their reason for cosmetic procedure. The inclusion criteria included all patients seeking cosmetic surgical procedures in the study period. The exclusion criteria were incomplete questionnaires. The data were used as a means to measure the increasing number of cosmetic procedures in various age groups. Pearson’s correlation was performed between the study variables and undergoing cosmetic surgery. Data and Statistical Package for Social Sciences software version 21.0 (SPSS Inc, Chicago, IL, USA) were used for data processing. A literature review was performed to obtain the demographic features of cosmetic procedures and surgeries of previous studies. No studies from the Kingdom of Saudi Arabia. ## Results The sample size was planned to involve 2,000 subjects; however, only 1,864 patients were assessed due to missing or incomplete data. Within this sample, 1,687 (90.5%) were females and 177 (9.5%) males and most were Saudis. Both single and married subjects had an equal aptitude for cosmetic procedures (**Table 1**). View this table: [Table 1](http://smj.org.sa/content/38/7/738/T1) Table 1 Demographic characteristics of patients. A total of 605 (26.2%) subjects underwent a laser hair removal, 439 (19%) underwent a Botox procedure, and 330 (14.3%) underwent liposuction (**Figure 1**). Most participants (578 or 31%) had a cosmetic procedure to look more beautiful. ![Figure 1](http://smj.org.sa/https://smj.org.sa/content/smj/38/7/738/F1.medium.gif) [Figure 1](http://smj.org.sa/content/38/7/738/F1) Figure 1 Percentages of patients underwent different types of cosmetic surgeries. ## Discussion External motivators for cosmetic surgery include the desire to avoid ethnic prejudice, fear of age discrimination, and direct or subtle, indirect coercion by a spouse. Internal motivators include the desire to diminish unpleasant feelings of depression, shame or social anxiety as well as the desire to obtain a powerful appearance that will facilitate career advancement.3 In 2005, there were 10.2 million cosmetic procedures performed in the United States, an increase of 11% from 2004 and a 38% increase compared with 2000.4 This number includes 3,839,387 Botox treatments, 1,033,581 chemical peels, 837,711 micro-dermabrasions, 782,732 laser hair removals, 589,768 vein sclera therapies (stripping), 323,605 liposuctions, 298,413 rhinoplasties (nose jobs), 291,350 breast augmentations, 230,697 blepharoplasties (eyelid reconstructions), 134,746 abdominoplasties, and 114,250 breast reductions. According to the statistics, 84% of patients undergoing cosmetic procedures were Caucasians and 90% were female.4 The top 5 minimally invasive procedures among women included Botox injection, chemical peel, laser hair removal, micro-dermabrasion, and sclera therapy. The top 5 surgical procedures were breast augmentation, liposuction, nose reshaping, eyelid surgery, and tummy tuck.5 Many studies describe the characteristics of cosmetic surgery recipients6,7 from other regions of the world, but there are no reports from Saudi Arabia. Thus, the present study was therefore undertaken. In our study, the prevalence of higher economic status among subjects may reflect a greater ability to access cosmetic surgery procedures, as would higher educational levels. These data can be used to note characteristics of future patients who can afford more cosmetic procedures. These data also reveal that in Saudi culture, while 20-40 years of age was the most common age at which individuals use cosmetic alterations, the extremes of age were not exempted and people older than 40 years of age were also seeking cosmetic renovations. Trends indicate that younger Saudis are also motivated to undergo cosmetic surgery procedures. This study showed that there are 2 significant subsets of patients represented with respect to partners, those older than their partners and those younger than their partners. The present study shows that the main reason for undergoing cosmetic procedures is to look more beautiful and to compete in attractiveness with other ladies in the pursuit of marriage. Some other motivational reasons include a person’s desire to look younger than their spouse (possibly in order to improve the security of their marriage), and younger Saudi women’s desire to have cosmetic surgery to look younger than their friends. ## Study limitations This study included a limited number of patients and included only 3 hospitals. Further pooled studies are desired to study the success of cosmetic surgery depending on baseline demographics and the outcome of this study. In conclusion, the results of this study could be helpful in determining needs and motivations among private practice patients. Additionally, it could assist in the development of marketing strategies for both physicians and companies with cosmetic products. ## Acknowledgment *I would like to thank Dr. Falah Syouri for data collection. I am also thankful to Ms. Norjanah Dimatunday for her help in data processing as well as checking and editing the required format for this article*. ## Appendix ![Appendix 1](http://smj.org.sa/https://smj.org.sa/content/smj/38/7/738/F2.medium.gif) [Appendix 1](http://smj.org.sa/content/38/7/738/F2) Appendix 1 Questionnaire given out to participating patients. ## Footnotes * **Disclosure.** Authors have no conflict of interests, and the work was not supported or funded by any drug company. * Received January 11, 2017. * Accepted April 13, 2017. * Copyright: © Saudi Medical Journal This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ## References 1. Li J, Li Q, Zhou B, Gao Y, Ma J, Li J (2016) Predictive factors for cosmetic surgery:a hospital-based investigation. 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