# Redefining Beauty: Knowledge, Attitudes, and Behaviours Toward Aesthetic Medicine and Cosmetic Surgery in Urban Adults

## TL;DR

This study explores how urban adults in Southern Italy understand and engage with aesthetic medicine and cosmetic surgery, finding widespread acceptance but gaps in knowledge about risks and regulations.

## Contribution

The study applies the KAP framework to assess aesthetic medicine practices in a Southern Italian population, revealing predictors of behaviors and knowledge gaps.

## Key findings

- 66.8% of participants reported general beauty treatments, with 9.8% using cosmetic procedures.
- Participants showed strong knowledge of non-surgical procedures but lacked understanding of side effects and regulations.
- Female sex and parental status were linked to aesthetic behaviors, with attitudes being the strongest predictor.

## Abstract

Background: In recent years, aesthetic medicine and cosmetic surgery have seen significant growth, reflecting changing sociocultural views on beauty and self-care; however, public knowledge and awareness of associated risks remain inconsistent. This study aimed to assess knowledge, attitudes, and behaviours toward aesthetic medicine and cosmetic surgery in a large metropolitan population in Southern Italy using the Knowledge–Attitude–Practice (KAP) framework. Methods: A cross-sectional survey was conducted between June 2021 and January 2022 among 1079 adults aged 18–72 years residing in the metropolitan area of Naples. A structured questionnaire collected socio-demographic data and assessed knowledge, attitudes, and behaviours related to surgical and non-surgical aesthetic procedures. Descriptive statistics and multiple linear regression analyses were performed to identify predictors of knowledge, attitudes, and behaviours. Results: Overall, 66.8% of participants reported having undergone general beauty treatments, while 9.8% declared the use of cosmetic medicine procedures. A total of 5.1% had undergone botulinum toxin treatments, 11% reported filler injections, and 9.8% had experienced plastic surgery. A majority had strong knowledge, especially on non-surgical procedures, but there were gaps in their knowledge on side effects, regulations, age limits, and qualifications. Most viewed appearance as important, though with critical views of excessive aesthetic treatments and claimed limited social media influence. Female sex and parental status were positively associated with aesthetic behaviours, while attitudes emerged as the strongest predictor of engagement. Conclusions: Aesthetic practices are widely accepted within this urban population, yet important informational deficiencies persist. Targeted educational interventions based on the KAP framework are warranted to enhance health literacy, promote safe decision-making, and foster realistic expectations regarding aesthetic medicine and cosmetic surgery.