Associations Between Adverse Childhood Experiences and Cosmetic Surgery: Effect Modification by Sexual Orientation

Few studies have investigated the impact of adverse childhood experiences (ACEs) on undergoing cosmetic surgery. Additionally, the association may differ by sexual orientation. This study aimed to identify the association between ACEs and undergoing cosmetic surgery, with analyses stratified by sexual orientation.

We analyzed responses from 27,824 participants aged 18-79 years from the 2023 Japan COVID-19 and Society Internet Survey. The participants reported ACEs, their cosmetic surgery experiences, and sociodemographic information. We used multivariate logistic regression analysis to examine the associations between ACEs and cosmetic surgery, including interaction terms with sexual orientation.

Individuals with 4+ ACEs were 2.97 times more likely to undergo cosmetic surgery (95% confidence interval [CI] 2.51-3.51) after adjusting for sociodemographic status. This association was stronger among non-heterosexual men (OR: 14.60, 95% CI 8.49-25.11, p < 0.001). Participants with 4+ ACEs were also more likely to report dissatisfaction with cosmetic surgery outcomes (OR: 1.92, 95% CI 1.36-2.71, p < 0.001).

Individuals with four or more ACEs were more likely to undergo cosmetic surgery, especially non-heterosexual males. In addition, participants with four or more ACEs were more likely to be dissatisfied with the surgical outcomes. These findings highlight the importance of considering psychosocial history, including ACEs, in cosmetic surgical assessment and patient care.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .