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Associations Between Adverse Childhood Experiences and Cosmetic Surgery: Effect Modification by Sexual Orientation
Takeshi Nomura1, Yukako Tani1, Takahiro Tabuchi2
1Department of Public Health, Institute of Science Tokyo, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Aesthetic Plastic Surgery
|October 31, 2025
Summary
Individuals with four or more adverse childhood experiences (ACEs) are more likely to undergo cosmetic surgery, particularly non-heterosexual men. Those with multiple ACEs also report higher dissatisfaction with surgical results, underscoring the need for psychosocial history in patient care.
Area of Science:
- Psychology
- Sociology
- Plastic Surgery
Background:
- Limited research exists on the link between adverse childhood experiences (ACEs) and cosmetic surgery.
- The association between ACEs and cosmetic surgery may vary by sexual orientation.
Purpose of the Study:
- To investigate the association between ACEs and undergoing cosmetic surgery.
- To analyze how sexual orientation influences the relationship between ACEs and cosmetic surgery.
Main Methods:
- Analysis of data from 27,824 participants (aged 18-79) in the 2023 Japan COVID-19 and Society Internet Survey.
- Multivariate logistic regression was used to examine associations between ACEs and cosmetic surgery, including interactions with sexual orientation.
Main Results:
- Individuals with 4+ ACEs were 2.97 times more likely to undergo cosmetic surgery.
- This association was significantly stronger in non-heterosexual men (OR: 14.60).
- Participants with 4+ ACEs reported higher dissatisfaction with cosmetic surgery outcomes (OR: 1.92).
Conclusions:
- Four or more ACEs are linked to increased likelihood of cosmetic surgery, especially among non-heterosexual males.
- Higher ACEs correlate with greater dissatisfaction with cosmetic surgery outcomes.
- Psychosocial history, including ACEs, is crucial for cosmetic surgery assessment and patient care.
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