Cosmetic Surgery and the Diversity of Cultural and Ethnic Perceptions of Facial, Breast, and Gluteal Aesthetics in Women: A Comprehensive Review

Abstract

An increasing number of people are opting for cosmetic surgeries. For many years, the physical and aesthetic appearance of Caucasians has been considered to be ideal. However, it is now commonly acknowledged that attractiveness and aesthetic standards vary among cultural backgrounds and ethnic groups and that Western attractiveness criteria no longer apply to all. Herein, we conducted a comprehensive review of studies that examined cultural and ethnic variations in preferences for facial, breast, and gluteal aesthetics, as well as reviewed studies that investigated ethnic disparities in attitudes and motivations for cosmetic surgery. A total of 4532 references were identified, 66 of which met the inclusion criteria. Several studies have reported that facial golden ratios are invalid for representing perceived attractiveness standards among different ethnicities. The majority of studies also indicated that facial aesthetic interventions should not aim to Westernize but to optimize ethnic traits. Significant ethnic differences in preferences for upper- and lower-pole breast proportions have been reported. The size of the buttocks and waist-to-hip ratio were identified as the main factors of buttock aesthetics, with buttock size preferences having a high ethnic diversity. Interest in cosmetic surgical procedures while maintaining ethnic identity continues to grow among young women worldwide. This comprehensive review strongly suggests that accommodating cultural and ethnic differences in aesthetic standards in cosmetic surgery planning can lead to more acceptable cosmetic outcomes.

Keywords: cosmetic surgery; cultural variations; ethnicity; golden ratios; outcome.

Figure 1

Study flow chart.

Figure 2

Ethnic variations of the phi mask. Reproduced from Sturm-O’Brien AK, Brissett AE, Brissett AE. Ethnic trends in facial plastic surgery. Facial plastic surgery: FPS. 2010;26(2):69–74. © Georg Thieme Verlag KG.

Figure 3

Frontal landmarks Asian (left) and Caucasian (right) attractive faces. Reproduced from Rhee SC. Differences between Caucasian and Asian attractive faces. Skin Res Technol. 2018;24(1):73–79. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Figure 4

Ideal breast illustrations; breast proportion, nipple angle, and shape and slope of the lower pole determine breasts aesthetics. Reproduced from Lee HJ, Ock JJ. An Ideal Female Breast Shape in Balance with the Body Proportions of Asians. Plastic and reconstructive surgery Global open. 2019;7(9):e2377. The Creative Commons license does not apply to this content. Use of the material in any format is prohibited without written permission from the publisher, Wolters Kluwer Health, Inc. Please contact. permissions@lww.com for further information.

Figure 5

Posterior view with varying WHRs in women. Reproduced from Nteli Chatzioglou G, Govsa F, Bicer A, Ozer MA, Pinar Y. Physical attractiveness: analysis of buttocks patterns for planning body contouring treatment. Surgical and radiologic anatomy: SRA. 2019;41(1):133–140, Springer Nature.