Influence of Social Media on Cosmetic Facial Surgeries Among Individuals in Kuwait: Employing the Theory of Planned Behavior

Madhawi Alduosari ¹ Dr Thurayya Albuloshi ² Ahmad Alsaber ^3* Farah Al Saeed ⁴ Anwaar Alkandari ⁴ Amal Anbar ⁵ Bedour Alboloushi ⁶ Yasser Helmy ⁷

• ¹ Ministry of Health, Kuwait City, Kuwait
• ² Palliative Care Center, Kuwait, Ministry of Health, Al Sabah Medical Area, P.O. Box 5, Kuwait City, Kuwait
• ³ American University of Kuwait, Safat, Kuwait
• ⁴ Business and Management Department, Kuwait Technical College, Kuwait, Abu-Halifa, Kuwait
• ⁵ Data Analytics department, ASIA Consulting for Administrative, Kuwait City, Kuwait
• ⁶ Department of Business and Management, Kuwait College of Science and Technology, Al Asimah, Kuwait
• ⁷ Plastic and Reconstructive Surgery, Al-Azhar University, kuwait, Cario, Egypt

The rising popularity of cosmetic facial surgery among Kuwaiti youth highlights the need to examine their willingness to undergo such procedures, especially given the significant influence of social media on shaping perceptions and behaviors. This study investigates the impact of electronic word of mouth (e-WOM), content marketing, and influencer marketing on attitudes, subjective norms, health consciousness, and intentions toward cosmetic surgery. Additionally, it considers cultural and psychological factors, including traditional values, family expectations, and body dysmorphic disorder, as well as ethical and legal considerations surrounding cosmetic procedures in Kuwait.A cross-sectional quantitative study was conducted with 730 participants, predominantly female (84.9%), using a validated Theory of Planned Behavior (TPB) questionnaire. Structural Equation Modeling (SEM) with SmartPLS was employed to analyze the data. Ethical approval was obtained, and informed consent was secured from all participants.The results indicate that subjective norms (SN) significantly influenced perceived behavioral control (PBC), which in turn affected the intention (INT) to undergo cosmetic surgery (β=0.336, p<0.001). Attitudes (ATT) also influenced PBC and subsequently INT (β=0.316, p<0.001), underscoring the role of personal beliefs shaped by social media. e-WOM had a strong impact on ATT (β=0.427, p<0.001) and SN (β=0.292, p<0.001), demonstrating the power of digital wordof-mouth in shaping perceptions. Content marketing (CM) and influencer marketing (IM) also played crucial roles in influencing ATT and SN, reinforcing the significance of digital promotions. The study found that subjective norms exert a stronger influence than personal attitudes in predicting behavioral intentions, reflecting the cultural emphasis on social approval in Kuwait.The findings highlight the significant role of social media in shaping attitudes and intentions toward cosmetic surgery among Kuwaiti youth. The strongest influence emerged from subjective norms affecting perceived behavioral control, which then impacted the decision to undergo surgery. Attitudes also played a key role, particularly through perceived behavioral control. Given these results, regulatory and policy measures are necessary to address ethical concerns, strengthen legal frameworks for cosmetic procedures, and implement social media-based interventions. These insights are essential for healthcare practitioners and policymakers to manage the growing demand for cosmetic surgery within cultural and digital contexts.