It is impossible to discuss body image in the present day without acknowledging the impact of various forms of media on body image. Extensive research links consumption of the media body ideals—that is, ultra-attractive and ultrathin or muscular images—with body dissatisfaction, negative self-esteem, and disordered eating beginning as early as preadolescence [4]. Even brief periods of viewing photographs of thin and round body images demonstrated an impact on viewers’ judgments of body shapes. Specifically, viewing images of thin bodies subsequently decreased viewers’ quality ratings of rounder bodies, whereas viewing images of fuller figures relatively increased ratings of round body shapes [5]. In men, for whom the media promotes a muscular body ideal, continuous exposure to images of ideal muscular bodies in advertisements is linked to increased body dissatisfaction [6]. In a more practical sense, women of average attractiveness are rated less beautiful when viewed after an attractive female in print media, and women underrate their own attractiveness immediately after viewing images of highly attractive women [7, 8]. Viewing frequency of reality television programs depicting cosmetic surgery not only correlates with body dissatisfaction but also increases willingness and perceived pressure to undergo cosmetic procedures [9]. Notwithstanding these potentially negative psychological effects to consumers induced by the depiction of unattainable body ideals, it is nevertheless naive to expect that a cultural vehicle as pervasive as the mass media impact will change considerably in the near future [10].

Parents may contribute to the development of body image in various ways. Direct parental comments about their child’s body size or appearance in clothing, for example, may heighten a child’s awareness of physical features from an early age. Males may be less affected by parental comments than their female counterparts [13]. Children may also learn to be dissatisfied about their bodies and looks by modeling parental concerns perceived through comments or weight-loss behaviors [14].

To remark that men and women internalize markedly different body ideals would be an understatement. Relative to women, men internalize a larger and more muscular ideal and are generally more satisfied with body size and weight, although men are more likely to feel dissatisfied by being too thin than women [16]. Along the similar vein, women associate a lower facial adiposity with higher attractiveness than do their male counterparts, and the degree of facial adiposity deemed ideal for attractiveness by women is lower than that considered ideal for health [17]. Women are also more likely than men to be dissatisfied with skin tone and color, and this is illustrative of a recurring theme of greater overall body dissatisfaction in females [18]. Perhaps due to this relatively lower prevalence of body image dissatisfaction, men may bear more of a stigma when it comes to seeking out cosmetic procedures, and historically are considered a more psychologically disturbed subset of patients. However, more contemporary views highlight that the majority of men pursuing cosmetic plastic surgery endorse no more global self-image dissatisfaction or attention to appearance than their peers, and rate significantly lower than that of females of the same age [19].

The awareness of one’s body begins early in childhood, and body dissatisfaction (particularly pertaining to weight) is well documented in girls and boys with prevalence increasing through the elementary years [14]. There exists an important link between the physical changes of puberty, body dissatisfaction, and clinical depression; and adolescent females with a negative body image are particularly at risk for future struggles with depression [20].

A great deal of research has examined the physical features most closely aligned with beauty, resulting in “ideal” ratios, shapes, and even favorable personality characteristics [25]. However, much of this early research included predominantly Caucasian subjects, and such facial features or proportions deemed attractive in Caucasians may not naturally exist or correlate with average features in non-white individuals. Culture and ethnicity are formative to the body image, and so one’s ideal image and future cosmetic enhancement will naturally fit within these parameters [26].