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Biomedical Research

An International Journal of Medical Sciences

Research Article - Biomedical Research (2018) Volume 29, Issue 10

Sociological study of the factors affecting body management (focusing on cosmetic surgeries in the city of Ahvaz, Iran)

Mostafa Haghi Karamallah1, Maryam Ghanavati2, Zahra Ghaderpour2, Mohamad Dianat3, Tajeh Jaderi3, Fariba Koti3, Fereidoon Najafi Shabankareh3*, Reza Fatalizadeh4

1Department of Sociology and Social Planning, Management and Social Sciences, Faculty of Economics, Shiraz University, Shiraz, Iran

2Department of Social Sciences, Shahid Chamran University, Ahvaz, Iran

3Development of Research and Technology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

4Ethic Committee of Chancellory for Research and Technology Development, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

*Corresponding Author:
Fereidoon Najafi Shabankareh
Development of Research and Technology
Ahvaz Jundishapur University of Medical Sciences
Ahvaz, Iran

Accepted date: January 23, 2018

DOI: 10.4066/biomedicalresearch.29-17-3184

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Background: At the present age, the appearance of body practices has been extensively highlighted. The body has been taken into consideration not only from the biological perspective, but also as a social and psychological product. The necessity of paying attention to the related explanatory factors has made this behavior an important and critical issue, which is a part of the appearance management behaviors. Therefore, this study was conducted aiming at determining the factors related to body management, with a focus on cosmetic surgeries.

Materials and Methods: This research was fulfilled as a cross sectional-descriptive survey in 2016. In this work, 172 individuals, who visited the cosmetic institutes and centers in the city of Ahvaz for cosmetic surgeries, were selected through random cluster sampling. Then, the data were collected through both questionnaires and interviews. Finally, the statistical tests, including Pearson, Spearman, and multivariate regression, were employed to analyze the obtained data.

Findings: It was comprehended that women do cosmetic surgeries more than men, and singles pay attention to their body appearance management more than the married ones. Moreover, unemployed housewives proceed to manipulate their body and appearance more than the employed women. Rhinoplasty (plastic surgery performed on the nose) had the highest demand and was the top rank. The next ranks belonged to cheek and lip prosthesis. It is worth stating liposuction and tightening the skin had their own advocates. While women and younger people were more inclined to rhinoplasty, cheek and lip prosthesis, men were more attracted to liposuction. In addition, old people were more interested in tightening the skin.


Cosmetic surgery, Body management


The body is not only a biological, cultural and social phenomenon, but also an indicator of the personal and cultural identity in today’s world. The body is formed in a social context, and its function and construct manifests socio-cultural beliefs [1,2]. Researchers believe that the body and the culture are inseparable [3]. In fact, it can be said that people imagine, the culture and the society in which they live, in their bodies. In a general sense, the body is a culture, with an expression of the basic subjects within the culture and the society. In other words, this change in the interpretation of beauty among the people of the society, as well as the industrial and medical achievements, have caused beauty to be not only a natural and biological characteristic, but also an acquired feature [4,5].

This clinical and acquired beauty is “a class-related beauty, which has a direct relationship with capital. This beauty is not only acquired by wealth, but also considered as wealth and capital per se, because by changing the beauty into an extra beauty, the facial processing can be entered into exchange markets in future” [6]. In other words, the body, beauty, and imaginative attractiveness in modern social relationships are considered as a physical capital, convertible to the other types of capital (i.e., economic, cultural and social capitals) [7]. Accordingly, as one of the indices of consumerism, the body beautification costs constitute a major part of the expenses of a family in consumer cultures [8].

Body management means to manipulate one’s body appearance. At the present age, the appearance of body practices has been specially highlighted. The body has been taken into consideration not only from the biological aspect, but also as a social and psychological product [9]. Therefore, body management means to constantly monitor and manipulate the apparent and visible features of the body. In fact, body management reflects a set of behaviors, including clothing and the accessories, procedure of makeup and beautification, and adjustment (change) of the body’s size and shape. It is worth indicating that body management behaviors range from routine daily behaviors (e.g., selecting a dress) to extensive forms (i.e., cosmetic surgeries) [10].

Given the above-stated explanations, it is clear that in contemporary societies, the body is no longer an organic construct and is rather a sociocultural phenomenon, and these societies effect on the bodies and their forms. Body management and surveillance are affected by the sociocultural situations and requirements, in which different factors, such as sociocultural capital, are influential [11].

Since nowadays, cosmetic surgeries are amongst the most common surgeries throughout the world and Iran is among the top ranks in terms of the ratio of cosmetic surgeries to population , and added to that, given the risk of doing such surgeries in which most applicants have no clinical need for doing such surgeries and they only intend to become more beautiful, and since these cosmetic surgeries have been changed to be a social phenomenon, body management has been converted into a sociocultural issue [12-14]. The necessity of paying attention to the explanatory factors has made this behavior an important and critical issue, which is a part of the appearance management behaviors.

As an industrial metropolis, Ahvaz is a developing city and is being modernized. The excessive increase in consumerism as well as the demonstrative consumption on one hand, and the exposure to mass media (such as satellites and other media) on the other hand, along with the possibility of using cultural products (such as book, newspaper, magazine, internet, satellite, cinema) and other technologies related to selfconstruction (cosmetic surgeries), have made individuals to adopt a modern viewpoint toward the society. Thus, they have decided to proceed to manage their body and appearance in order to build their personal identity in a modernizing society. Therefore, given the above-mentioned points, studying the body management behaviors is of special importance to recognize its status in the society and explain it sociologically.


This sectional research is of analytical type. The cluster sampling technique has been employed in this research as a study at relatively large scale so that the cosmetic centers and institutes of Ahwaz city were initially divided into 8 clusters and then two centers were randomly selected from any cluster and the questionnaire forms were distributed between referents to these centers where they intend to operate cosmetic surgery. In addition to background variables, the given questionnaire are used for measurement of research variables such as items of religiosity variable as well as variable of self-esteem in which 15 items are utilized and also variable of cultural capital with 14 items and variable of influence by reference groups and after collection of questionnaires data analysis will be done by SPSS software.

In this study, statistical population includes all persons who have referred to one of the cosmetic surgery centers in Ahwaz city for this operation during studied period (21st March-21st September 2016). In order to possess the reference sample based on constraints of this study, it has been tried to use plans of possible sampling (cluster and systematic samplings) on the one hand and to select sample with 172 participants who have been operated for cosmetic surgery within studied period by means of Cochran’s formula.


The frequency distribution of other background variables is given in table of demographic variables (Table 1). The findings indicate that the females tend more to cosmetic surgery than males and the single persons attach more importance to managing their physical appearance than the married ones. Similarly, unemployed persons and householder females try to manipulate their body and appearance more than the employees and also persons with medium level education (bachelor’s degree) show further interest than other groups to operate cosmetic surgeries and body management.

  Variable Number Percent
Gender Female 140 0.814
Male 32 0.186
Married 44 0.256
Marital status Single 108 0.628
Divorced 20 0.116
Elementary 4 0.023
High school 7 0.04
Education Diploma 30 0.175
Bachelor 104 0.605
Up of bachelor 27 0.157
Employment status Employed 58 0.337
Unemployed 114 0.663

Table 1: The frequency distribution of background variables.

The findings in Figure 1 indicate that the maximum number of applicants asks for rhinoplasty (nose surgery). This rate is placed at first rank distant from other operation and face and lip prostheses are ranked at the subsequent positions. The suction of topical fats (liposuction) and facelift surgery are also welcomed by the specific adherents. The females and the younger people are more inclined to rhinoplasty and face and lip prostheses while the males show further interest in operation such as local liposuction and the old people more wish facelift surgery (rhytidectomy).


Figure 1: Findings of number of applicants.

We employed Pearson’s correlation test to examine research hypotheses in section of inferential statistics. As you observe in Table 2, it was characterized that there was significant relationship among variables of self-esteem, religiosity, cultural capital, social base (objective and subjective), and age with operation of cosmetic surgery and the results of this study showed that the sociability was not significantly related to execution of cosmetic surgery so the research hypothesis was rejected.

Variable Pearson correlation coefficient 1 -0.044
Appearance management Significant level 0 0.002
Self-esteem Number 172 172
  Pearson correlation coefficient 1 -0.194
Appearance management Significant level 0 0.006
Religiosity Number 172 172
  Pearson correlation coefficient 1 0.498
Appearance management Significant level 0 0
Cultural capital Number 172 172
  Pearson correlation coefficient 1 -0.308
Appearance management Significant level 0 0
Age Number 172 172
  Pearson correlation coefficient 1 0.014
Appearance management Significant level 0 0.899
Social acceptance Number 172 172
  Pearson correlation coefficient 1 0.311
Appearance management Significant level 0 0
Social base (objective and subjective) Number 172 172
  Pearson correlation coefficient 1 0.331
Appearance management Significant level 0 0
Subjective social base Number 172 172
  Pearson correlation coefficient 1 0.133
Appearance management Significant level 0 0.047
Attitudes of other people Number 172 172

Table 2: Research hypotheses in section of inferential statistics.

As it is shown in results of Table 3, the multiple correlations coefficient for linear combination of independent variables with appearance management is (MR=0.686) and determination coefficient as (R2=0.470) that is significant at level (p<0.000). Thus it is identified 47% of variance of appearance management can be determined by predictor variables.

R2 Multiple regression Significant level of F F
0.47 0.686 0 29.32

Table 3: Variance of appearance management.

Moreover, stepwise regressive data analysis indicated that these variables might affect in prediction of appearance management respectively: cultural capital (β=0.49, p<0.001), subjective social base (β=0.33, p<0.001), objective social base (β=0.31, p<0.002), age (β=0.26, p<0.001), religiosity (β=0.23, p<0.003), attitudes of other people (β=0.18, p<0.029) and selfesteem (β=0.17, p<0.012). Nonetheless, variable of sociability (β=0.097, p<0.526) did not play significant role in prediction of appearance management (Table 4).

Variable B SE ß T P-value
Constant 13.21 15.18   4.36 0.001
Cultural capital 0.336 0.088 0.498 5.31 0.001
Subjective social base 0.251 0.131 0.33 4.14 0.001
Social base (objective and subjective) 0.233 0.113 0.31 3.74 0.002
Age 0.201 0.145 0.261 2.55 0
Religiosity 0.146 0.229 0.232 2.24 0.003
Attitudes of other people 0.102 0.243 0.182 1.88 0.029
Self-esteem 0.115 0.271 0.171 1.14 0.012
Social acceptance 0.101 0.344 0.097 0.866 0.526

Table 4: Data analysis of appearance management.


Body (appearance) has been increasingly highlighted in consumer cultures, which has also brought ostentation (showoff) with itself. Based on the concept of ostentation, the body is considered as a machine, required to be protected and reconstructed, in addition to being accurately adjusted. The type of makeup and the body appearance are the identity elements, by which people define their own identities [15]. The fact that people are interested to be perfect, attractive and glamorous is to be able to control their body and to use diverse and creative life styles are the results of modernism.

For example, the consumer culture encourages people to view the skin, particularly the women’s skin, as something that always needs constant processing in order to be protected against the passage of time, in such a way that the skin can maintain its gender difference in the form of the softness of feeling [16]. The body acts as an intermediate between consumption and personal identity, and has become the main arena for exposing the differences [5,16].

This result complies with Bourdieu’s theory. Bourdieu exhibited the effect of cultural capital on the life style of individuals with the aid of the theory of distinction. According to this theory, people distinguish themselves from others based on the level of their cultural capital. Therefore, cultural capital causes people to incline to specific life styles [7]. Since the appearance management is regarded as one of the major indices and components of life styles, it can be stated that because the cultural capital affects the people’s life style through their initiative and taste, it somehow influences how people manage their body as one of the life style components [17,18].

In fact, the perspectives carved into our mind, representing the presumptions that goodness is always accompanied with beauty and badness with ugliness, have caused different societies to constantly demand beauty, considering the changes in the understanding and interpretation of beauty in different periods. The main difference between beauty in the modernist era and the other eras is that, thanks to medical achievements, beauty has transformed from an inborn feature to an acquired characteristic, and is being continuously reproduced as a symbol and indicator of the high social position [19].

Most of the people, who do cosmetic surgeries, belong to the low and medium social classes. The spread of such surgeries to acquire beauty among the low and medium social classes has enormous expenses for acquiring the external signs of the superior social status. Regardless of the social classes and statuses, the results of the present work confirmed that women consist of a major share of the people, who do cosmetic surgeries. This can indicate the fact that beauty for women is socially more important than for men. This ratio holds true in all societies with slight differences. This priority that may result from the connection between women and the principle of beauty, or the role of women in the consumption of dignity symbols, or their more attachment to fashion markets, have made women the dominant consumers of the beauty market [20,21].

Furthermore, there exists a significant relationship between religiosity and body management. This is an inverse relationship with low intensity. This result conforms to the studies conducted by Azadarmaki et al. [22-24]. Body management and its instances (including cosmetic surgery and body manipulation), which have prevailed in Iran’s society, are not in agreement with the Islamic instructions and cannot be covered in them. Islam expresses the most important feature of the women’s clothes as not to be showy, whereas what has occurred in the society has been to determine the way women cover themselves, instead of specifying the limits, and to impel them to wear a long uniform or a large veil [22-24].

The emphasis by the government, the religion, the convention and the law on complete covering and determining the form of dresses, have caused women to implement their body management on the main part of their appearance (i.e., their face), which has the least limitations to show it off in the society. That is why Iran has been ranked at the top of many other countries in terms of consuming the cosmetics and doing the cosmetic surgeries [25,26].

According to Giddnes, in the new era, some of the appearance symbols and the body practices have been specially highlighted [27]. This contradiction can be justified relying on this theory that the less dependent on the religion, the society becomes semantically and in turn, the more dependent on the science, the more widely the body physiology will be manipulated. This body manipulation is exerted by both social norms and the scientific community. In this regard, Elias described this situation using some concepts, such as body rationalization and socialization.

Conflict of Interest

The authors declare no conflict of interest.