"We are no drawings, no clay dolls": A qualitative exploration of adolescents' attitudes towards cosmetic procedures.

Most previous research into cosmetic surgery acceptance/intention is quantitative in nature and focuses on (female) adults. Yet, qualitative explorations of adolescents are required, as they form the next generation of cosmetic consumers and are growing up in a culture in which procedures are unprecedentedly normalized. Moreover, the number of young people undergoing cosmetic procedures is increasing. This study explores adolescents' attitudes towards cosmetic procedures and (future) cosmetic procedure intention through 13 focus groups with a total of 42 adolescents (aged 15-19). The sample included variation in terms of gender identity, educational level/attainment, and regionality. The focus groups were analyzed using reflexive thematic analysis, which resulted in five main themes, providing a comprehensive overview of adolescents' attitudes towards cosmetic procedures. The first theme, information (sources) illustrates adolescents' knowledge of cosmetic procedures and how adolescents obtain information related to cosmetic procedures, which may also explain some of their views and attitudes. The second theme, normalization of a commercial industry, explores the adolescents' discussion of the normalized status of cosmetic procedures, both in the Netherlands and abroad. The third theme, attitudes towards cosmetic procedures, engages with the varied, variable, and context-specific (dis)approval and evaluation of cosmetic procedures. Following this, the fourth theme - cosmetic procedure intention - elaborates on the adolescents' expressions of their own (lack of) intention to undergo cosmetic procedures. The fifth and final theme was construction and identification of 'the cosmetic consumer', where adolescents distanced themselves from the cosmetic surgery industry and/or shared particular (stereotypical) constructions of recipients of cosmetic procedures. This study provides an examination of adolescents' perceptions of and attitudes towards cosmetic procedures. Importantly, we found that adolescents' attitudes can be characterized as complex and ambiguous. To explain this ambiguity, we consider insights from Cultivation Theory (Gerbner et al., 2002), the cosmetic surgery paradox (Bonell et al., 2021), and connect the adolescents' discussions to issues of diversity.