Grace Barker and her team at Griffith University's School of Applied Psychology have created something that didn't exist before: two new psychological tools to measure how people really think and feel about cosmetic procedures. As non-surgical treatments have exploded in popularity—jumping from 11.5 million procedures globally in 2015 to more than 20 million in 2024—researchers realized the old ways of understanding attitudes toward cosmetic work were no longer enough.
The distinction matters more than it might seem. When someone considers a facelift versus a botox injection, they're weighing entirely different calculations. Surgery means cutting, permanent commitment, significant cost, and substantial recovery time. Non-surgical procedures involve piercing the skin rather than cutting it—botox and filler injections promise reversibility, lower cost, and faster results. These differences reshape how people perceive risk, accessibility, and whether the procedure has become socially normal. Barker and her colleagues recognized that attitudes toward these two categories couldn't be lumped together anymore.
The study, published in the journal Body Image and co-authored by Dr. Veya Seekis and Professor Caroline Donovan, involved 723 individuals identifying as women from Australia and internationally. Women were the focus deliberately. They comprise 84% of cosmetic procedure patients globally according to the International Society of Aesthetic Plastic Surgery, and they face disproportionate exposure to appearance-related messaging across social and digital media—what Seekis called "systemic pressures, societal expectations, and gendered appearance norms."
The two new assessment tools—collectively called the Cosmetic Procedure Attitudes Scale (CPAS)—measure something deceptively complex: attitudes themselves. An attitude, the researchers explain, is formed by beliefs and evaluations toward an object, behavior, or person. The scales capture three layers of consideration. First, intrapersonal factors: how does a procedure affect your self-esteem and confidence? Second, interpersonal factors: will it help you form bonds with others, meet social expectations? Third, practical factors: what about the risk, cost, and pain involved?
What makes this tool different is its focus on individual perspective rather than broad generalizations. "The scale focuses on an individual's own views rather than broad or generalized opinions, allowing for a better understanding of personal differences," Donovan said. This distinction opens doors to more targeted support. The researchers hope their work will help psychologists and clinicians identify people particularly vulnerable to appearance-related distress—those struggling with complex body image concerns or conditions like body dysmorphic disorder—and develop prevention strategies tailored to their needs.
As cosmetic procedures become more accessible and affordable, understanding the psychological motivations driving people toward them becomes increasingly important. These new measurement tools give researchers a much sharper lens. They can now track how social factors shape attitudes over time, recognize when appearance concerns might signal deeper psychological struggles, and intervene with precision rather than assumption. In a world where cosmetic procedures are becoming routine, having rigorous ways to understand why people pursue them—and who might need support—represents genuine progress.