THE CONTENT OF COSMETIC SURGERY MAGAZINE ...

[Pages:236]THE CONTENT OF COSMETIC SURGERY MAGAZINE ADVERTISEMENTS AND

CONSUMER USE AND INTERPRETATIONS OF COSMETIC SURGERY ADVERTISING

by

HEIDI J. HENNINK-KAMINSKI

(Under the Direction of Leonard N. Reid and Karen Whitehill King)

ABSTRACT

Cosmetic surgery in the United States has experienced unprecedented growth, representing a $9.4 billion industry in 2005. Although increased marketing and promotional activity have contributed to this growth and physician advertising remains controversial, little is known about the content of cosmetic surgery advertising messages or its affect on consumers. This dissertation explores the manifest content properties of cosmetic surgery advertisements over a 20 year period, as well as consumer use and interpretations of such advertising, using social comparison theory and the Sarwer model as frameworks. Stage one of the study analyzes the appeals, physical characteristics, human model characteristics, physician characteristics, risk information and inducements within 1,857 cosmetic surgery advertisements placed in city magazines from 1985 to 2004. Among the findings: promotional activity increased significantly over time; most advertisements employed rational vs. emotional appeals; a surprisingly low percentage included risk information; the use of monetary incentives increased over time; and most ads responsibly portrayed before and after photos and avoided exploiting fears, anxieties or other emotional vulnerabilities. Stage two of the study involved in-depth interviews with women about their use of cosmetic surgery advertising, confirmation or disconfirmation of expectations set by advertising, and perceptions of cosmetic surgery advertising vs. to other types of physician advertising. The findings: cosmetic surgery advertising was used early in the information search and played a relatively minor role compared to other information sources; it was used primarily for awareness of physicians in their market, their credentials, and new cosmetic surgery procedures; and it helped set expectations for both process and appearance outcomes. Ads with before and after photos were considered the most persuasive while ads that ignored the impact of individual differences on appearance outcomes, made life-changing promises, or failed to disclose when a model was not a patient were considered to be unethical. In addition, participants neither recalled nor expected to see risk information in ads and had mixed opinions on how risk information might impact physician credibility. Methodological limitations are presented, followed by suggestions for advancing cosmetic surgery advertising research.

INDEX WORDS:

cosmetic surgery advertising, cosmetic surgery marketing, physician advertising, appeals in cosmetic surgery ads, health communication and information, social comparison theory, Sarwer model

THE CONTENT OF COSMETIC SURGERY MAGAZINE ADVERTISEMENTS AND CONSUMER USE AND INTERPRETATIONS OF COSMETIC SURGERY ADVERTISING

by HEIDI J. HENNINK-KAMINSKI B.A., University of Michigan, 1987 M.A., Western Michigan University, 1992

A Dissertation Submitted to the Graduate Faculty of The University of Georgia in Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY ATHENS, GEORGIA 2006

? 2006 Heidi J. Hennink-Kaminski

All Rights Reserved

THE CONTENT OF COSMETIC SURGERY MAGAZINE ADVERTISEMENTS AND CONSUMER USE AND INTERPRETATIONS OF COSMETIC SURGERY ADVERTISING

by

HEIDI J. HENNINK-KAMINSKI

Major Professor: Committee:

Leonard N. Reid Karen Whitehill King

Vicki Freimuth Jeffrey Springston Spencer Tinkham

Electronic Version Approved:

Maureen Grasso Dean of the Graduate School The University of Georgia December 2006

DEDICATION For Cole

My gift, my joy, my inspiration

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ACKNOWLEDGEMENTS A number of people have helped make this journey possible, either by encouraging me to undertake the doctoral path or contributing to my success once the program was underway. First, I would like to thank my parents, Bob and Jan Hennink. From childhood they instilled the belief that I could accomplish anything I set my mind to and encouraged me to use the gifts that God gave me. In addition, I appreciate the influence of Quentin Schultze, Richard Gershon and Randall Bytwerk who served as friends and mentors as I charted my vocational course. I am also grateful for the supportive environment of Grady College. Leonard Reid mentored me with sound strategic counsel during the past three years and Karen Whitehill King provided guidance, encouragement, empathy, and friendship. I also benefited from the knowledge and support of Vicki Freimuth, Jeffrey Springston and Spencer Tinkham. Graduate students Amy Jo Coffey, Lisa Pecot Hebert, Beth Johnson Avery, Amanda Hall Gallagher, and Gary Guffey have become friends for a lifetime, as have Carolina Acosta-Alzuru and Peggy Kreshel. I am particularly indebted to Lavon Herring and Debbie Sickles, who provided a safe, loving and nurturing environment for Cole from the moment he was born. I could not have finished this degree without their unwavering and dedicated support. Finally, I would like to thank my husband, Bob Kaminski, for his support during these hectic and demanding years.

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TABLE OF CONTENTS Page

ACKNOWLEDGEMENTS .............................................................................................................v LIST OF TABLES......................................................................................................................... ix LIST OF FIGURES ....................................................................................................................... xi CHAPTER

1 INTRODUCTION .........................................................................................................1 2 REVIEW OF THE LITERATURE ...............................................................................8

A Definition of Cosmetic Surgery.............................................................................8 U.S. Cosmetic Surgery Statistics...............................................................................9 A Brief History of Cosmetic Surgery Advertising..................................................10 Theoretical Frames ..................................................................................................12 Previous Research about the Mass Media and Cosmetic Surgery ..........................15 Previous Research on Cosmetic Surgery Advertising.............................................16 Research Questions: Stage One...............................................................................19 Research Questions: Stage Two ..............................................................................28 3 METHOD ....................................................................................................................37 Stage One Method ...................................................................................................37 Stage Two Method ..................................................................................................47 4 RESULTS: STAGE ONE ............................................................................................59 Sample Characteristics ............................................................................................59

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Advertising Appeals ................................................................................................63 Human Model Characteristics .................................................................................65 Risk Information......................................................................................................68 Inducements.............................................................................................................69 Physician Characteristics.........................................................................................70 Physician Credentials ..............................................................................................72 Advertisement Characteristics by Physician Gender ..............................................75 Advertisement Characteristics by Practice Type ....................................................77 5 RESULTS: STAGE TWO ...........................................................................................97 Participant Characteristics .......................................................................................97 Encounters with Cosmetic Surgery Advertising .....................................................98 Use of Advertising...................................................................................................99 Risk Information....................................................................................................108 Confirmation/Disconfirmation of Expectations ....................................................111 Cosmetic Surgery Advertising vs. Other Types of Physician Advertising ...........114 Physician Gender and Perceptions of Cosmetic Surgery Advertising ..................120 Type of Practice.....................................................................................................125 6 SUMMARY OF FINDINGS, DISCUSSION AND FUTURE RESEARCH ...........128 Sample Characteristics and Physical Properties of Advertisements .....................128 Message Strategy Properties .................................................................................132 Executional Components Content Properties........................................................134 Comparative Questions Regarding Advertising Sources ......................................147 Theoretical Observations and Implications...........................................................151

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