Abstract
Background: Cosmetic surgery is gaining popularity day by day and one primary cause for this hype is the widespread growth of social media. Exposure to social media gives individuals greater body image concerns, which enhances their decision to expose to cosmetic surgery. The Kingdom of Saudi Arabia ranks 22nd among the top 25 countries with the highest rate of cosmetic surgery globally. There is practically no research regarding this aspect in the Kingdom of Saudi Arabia. The aim of the study was to study the impact of social media engagement on body image and increased popularity toward seeking cosmetic surgery in Al-Ahsa city, Saudi Arabia.
Methods: A cross-sectional study was carried out in Al-Ahsa city, Saudi Arabia, in 2019–2020. A total of 513 subjects participated in this study. Subjects were selectively chosen to fill the online Social Media Engagement Questionnaire to assess the engagement with social media. The Body Appreciation Scale was used to assess an individual’s body appreciation and acceptance of cosmetic surgery scale and to assess the decision-making to perform cosmetic surgery. Data were analyzed using Pearson’s correlation and analysis of variance tests, with a level of significance at p < 0.05.
Results: Among the participants, 98.6% of the subjects used social media for 3-5 hours daily, 24% used it for 6-10 hours daily, 18.4% of them used it for less than 2 hours, and 10.5% used it for more than 10 hours daily. The usage of social media, especially 15 minutes before sleep and 15 minutes after waking up, is highly linked to the decision-making to perform cosmetic surgery (p < 0.05). Body appreciation and body image are very important factors to consider for cosmetic surgery performance (p < 0.05).
Conclusion: This study suggests that social media engagement has an impact on body appreciation and decision- making to perform cosmetic surgery in a way that needed to be studied.

Key words: Social Media, Cosmetic Surgery, Body Appreciation, Plastic surgery, Saudi Arabia.