Cosmetic Surgery in Iran, based on Reference Group, Attitude, and Perception Theory

1.0 Introduction

Cosmetic surgery has become a new lifestyle in this contemporary days, moreover
cosmetic surgery has developed to be a new culture and also a new intention for people to
spend their income. Ma Xiaowei, China Vice Health Minister stated that the cosmetic
surgery were the fourth most popular way to spend discretionary income by Chinese, after
houses, cars, and travel (LaFraniere, 2011).

According to the International Society of Aesthetic Plastic Surgery, in 2013 there

were more than 11.5 million cosmetic surgeries performed worldwide (Honig, 2014). The
data explicitly indicated that there was a lot of cosmetic surgery enthusiast around the
world. The most eminent pervasiveness of cosmetic surgeries are transforming the original
shape of the eyelid, nose, breast, and lips.

Cosmetic surgery refers to a subspecialty that is concerned primarily with the

maintenance, restoration, or enhancement of an individual’s physical appearance through
surgical and medical techniques (Swami, 2008). Therefore, cosmetic surgery becomes
interesting to explore because, in several countries, cultures, and religions, cosmetic surgery
is prohibited and considered taboo. One religion that forbid their coreligionists to perform a
cosmetic surgery is Islam.

According to the cosmetic surgery in the Islamic law perspective, Bishara (2013)
stated that muslims should be satisfied with the way God has created them. Meanwhile,
Sheikh Mohammed Al-Nujaimi (2013) a member of the International Islamic Fiqh Academy
in Saudi Arabia indicated that it is permissible to perform surgery to correct a birth defect or
to reserve damages incurred from an accident. However, cosmetic surgeries violate the
Islamic ‘fatwa’ against altering God’s creation.

Even though Islam expressly disallow their people to perform a cosmetic surgery,
data shows that there has been an increasing number in cosmetic surgery at countries that
the majorities of the citizens were muslims, such as Iran. According to The International
Society of Aesthetic Plastic Surgeons, Iran surprisingly ranked 8th in the world for plastic
surgery for face and head procedures with over 56.944 amount of surgeries (ISAPS, 2013). In
addition, Iran has been named as the nose job capital of the world because of the number of
nose surgeries are seven times more than in US (Kirkova, 2013).

It seems possible that these results are due to the changing of behaviours in Iranian
point of view, therefore in the next session this essay will analyse three factors that were
altering Iranian behavioural changes towards cosmetic surgery. (406 words)
2.0 Perception

2.1 Perception of Beauty

The perception about beauty has changed by years. Every century had their own beauty
model, eventough the perception about beauty remains same, only a little bit of differences
of perception changing by years.

Masuknya budaya modern melalui media, baik melalui televisi, internet ataupun
media cetak telah membuat banyak perubahan terhadap cara pandang masyarakat
mengenai kecantikan. Melalui tayangan-tayangan dan iklan-iklan yang menarik, media
menawarkan bentuk kecantikan ideal yang membuat seseorang menjadikan gambaran
tersebut sebagai standar kecantikan yang diidamkan. Media asing, khususnya media yang
berasal dari barat menampilkan symbol kecantikan yang dianggap sempurna melalui
gambaran fisik seperti hidung yang mancung, tubuh yang langsing, dan kulit yang bersih.
Gambaran kecantikan fisik yang disebut ideal itulah yang akhirnya membuat seseorang
dapat membentuk sebuah persepsi atas kecantikan.

Dengan terbentuknya persepsi atas kecantikan tersebut, daya tarik untuk merubah
diri menjadi lebih cantik pun semakin meningkat. Melalui media pula lah berbagai cara
untuk menyempurnakan diri menjadi lebih cantik ditawarkan, salah satunya adalah dengan
melakukan cosmetic surgery. Persepsi atas cosmetic surgery di masyarakat pun perlahan
berubah dari yang dianggap tidak wajar menjadi sesuatu yang umum dan dapat diterima.

Sebelum memutuskan untuk melakukan sebuah tindakan, seseorang pasti memiliki

persepsi terhadap suatu hal tersebut. Schiffman (2008) defined perception as the process by
which an individual selects, organizes, and interprets stimuli into a meaningful and coherent
picture of the world. It can be described as “how we see the world around us”. Stimuli yang
didapatkan oleh seseorang natinya akan melalui proses di dalam diri disesuaikan dengan
beberapa factor yang membentuk sebuah persepsi. Faktor-faktor yang mempengaruhi
persepsi tersebut antara lain adalah needs, wants, values, beliefs, personal experiences,
moods, and expectations. (Batra et al, 2009)

Teori tersebut di atas juga berlaku pada masyarakat Iran terkait dengan persepsi
mereka tentang kecantikan dan cosmetic surgery. Bagi para wanita di Iran, kecantikan wajah
adalah sesuatu yang ingin mereka tampilkan. Karena sejak revolusi Iran pada 1979,
perempuan Iran diharuskan memakai hijab dan pakaian tertutup dari kepala hingga kaki. Hal
ini membuat para wanita di Iran tidak dapat bebas berpenampilan seperti yang mereka
inginkan. Walaupun demikian, perempuan Iran tetap berusaha untuk berpenampilan
menarik seperti yang mereka idamkan. Salah satu usaha yang mereka lakukan adalah
dengan melakukan cosmetic surgery, khususnya di bagian hidung. (The Guardian, 2013)

Seorang wanita Iran yang menempuh jalur cosmetic surgery untuk memperbaiki
hidungnya dalam The Guardian (2013) menyatakan bahwa Ia merasa memiliki kehidupan
social dan kepercayaan diri yang lebih baik setelah ia mendapatkan hidung yang
diidamkannya. Berdasarkan artikel tersebut, dapat terlihat sebuah gambaran bahwa
cosmetic surgery bagi sebagian wanita di Iran telah menjadi solusi untuk mengubah perespsi
mereka tentang dirinya sendiri dari apa yang mereka yakini sebelumnya buruk menjadi lebih
baik. Ekspektasi sebagian wanita Iran tentang apa yang akan terjadi di masa depan setelah
melakukan operasi juga mendorong mereka untuk membentuk sebuah persepsi positif
mengenai cosmetic surgery. Dalam The Guardian (2013) mereka berekspektasi bahwa bila
mereka tampil lebih cantik, maka mereka bias mendapatkan tempat yang lebih baik di
masyarakat dan dapat berpeluang untuk mendapatkan suami yang sesuai dengan kriteria
mereka.

Meskipun di Iran dan Negara Islam lainnya cosmetic surgery itu dilarang karena
dianggap akan merubah ciptaan Tuhan, kenyataannya banyak masyarakatnya yang
melakukan operasi. Hadith: "Allah is beautiful and loves beauty." (Related by Muslim #131)
menjadi sebuah referensi bagi wanita yang ingin melakukan cosmetic surgery di Iran. (Davis,
2008) Anjuran untuk senantiasa menjaga kecantikan dalam hadith tersebut membuat wanita
di Iran menganggap bahwa mendapatkan kecantikan melalui cosmetic surgery adalah
sesuatu yang wajar dan tidak melanggar nila dan norma agama.

3.0 Reference Group

One factor that influence the decision making for Iranian on undertaking cosmetic
surgery is the presence of the reference group. A reference group is a person or group of
people that significantly influences an individual’s behaviour (Beardon and Etzel, 1982 in
Blythe, 2013). From a marketing perspective, reference groups are groups that serve as
frames of reference for individuals and their purchase or consumption decisions (Schiffman,
2008). As we know, human tends to be a social creature who like to interact to others, not
only as individual but also as a group.

Reference group has grown in a broader area in these recent years. Previously,
people only knew that the reference group only focuses on people who knew each other
such as family, friends, etc. However nowadays every people can stand as the reference
group. This theory were explained clearly by Schiffman (2008) where he divided the
reference group into two categories, direct reference group are a person who interacted on
a direct basis, such as family and close friends, on the other hand, indirect reference group
consist of those individuals or groups with whom a person does not have direct face to face
contact, such as film stars, sport heroes, political leaders, or even well dressed and
interesting looking people in the street.

In my opinion, direct and indirect reference group did not work independently, but
these two aspects interrelated to influence Iranian on decision making. As an example,
direct reference group such as friend and family are watching an advertisement of a latest
product from television, and subsequently they influence their family to purchase the
product. Therefore a person could be influenced by their direct reference group whereas it
is also being influenced by their indirect reference group.

Direct and indirect reference group also can give a different approach to people,
depends on their social class. Social class is determined by a complex set of variables,
including income, family background, and occupation (Solomon, 2014). Because it needs a
lot of money to do a cosmetic surgery, it could be assumed that the probability of people in
middle top category is bigger to go under the knife than people in the middle low category.
In this case, if the person’s social class is a middle top category, the direct reference group
such as friend could exist as a referent power. It can inform and make people aware of the
product and also can influence to adopt the attitude whereas people tend to perform just
like their friend. Meanwhile if a person social class is on middle low category, the indirect
reference group play a big role on influencing this type of social class.

As explained before, Islamic law prohibit muslims to undergo a cosmetic surgery,

according to that, indirect reference group possible play a big role on changing Iranian
behavior, more than direct reference group. This become possible because of the media
globalization that made a lot of access for people to find an information about cosmetic
surgery. One other factor that support this kind of reference group is the technology
development.

Direct reference group such as from family should be the first reference from people
before deciding to do a cosmetic surgery. In this case a positive reference group such as
religious man should work extra hard on responding this issue. However, this type of
reference group did not get big attention from Iranian who perform a cosmetic surgery. (570
words)

4.0 Attitude

Every people has a different attitude. According to Schiffman (2008), an attitude is a

learned predisposition to behave in a consistently favourable or unfavourable way with
respect to a given object. In addition Blythe (2013) stated that attitude is learned, not
instinctive. Attitude did not stay constant; it changes and develops. Attitudes develop over
time through the learning process affected by family influences, information and experience,
and personality (Assael 2004).

The Iranian was bombarded my media every day. The definition of beauty whereas it is
relative changes into absolute and then spontaneity that designation stays in people’s mind.
Iranian also being teached about the definition of beauty and also the advantages of being
beauty. In movies, lots of antagonist characters were played by people who are not looking
good. Meanwhile, the protagonist characters were played by people they think has a good
looking face. Movies also influence people about the advantages of being beautiful, such as
easy to find a soulmate, lots of job vacations, being loved by lots of people, etc.

Every day, Iranian not only influenced by movies about the perception of beauty, Moslems
also being influenced by advertisement. Mostly every advertisement shows a beautiful
woman who has the same standard of beauty. The funny thing is because the function of
advertisement is to sell their product, so they made a different standard of beauty in every
side of the world. As an analogy in the Europe and US, the cosmetic advertisement mostly is
to make skin darker, meanwhile in South Asia and in South East Asia, the beauty
advertisement is to make people whiter.

Because of the media attack, Iranian unknowingly slowly change their attitude about
beauty. Iranian started to seek information of how to become beautiful based on the
media’s interpretation. Because of the traditional way take lots of time, they begin to try to
use the short way by doing cosmetic surgery. Even though it is clearly said that Moslems was
forbid to do a cosmetic surgery, however the high rank of of cosmetic surgery in Iran
indicated that there has been a changes of attitude from Iranian on cosmetic surgery. The
influence by media succeed to enter the fourth dimension of attitude function, which is: (1)
Utilitarian Function, (2) Value-Expressive Function, (3) ego defensive function, (4) Knowledge
function (Solomon, 2013).
 From the utilitarian perspective, Dari segi utilitarian function sangat jelas bahwa
setiap manusia tidak memerlukan untuk menjadi cantik apalagi sampai memakai cara
express seperti cosmetic surgery, namun dikarenakan asas kebermanfaatan yang dibuat
oleh film membuat hal tersebut menjadi sangat bermanfaat, Dari segi value expressive ….
Dari segi ego devensive juga tidak berlaku lagi mengingat pengaruh dan tekanan yang hadir
setiap saat. Terakhir mengenai knowledge media seakan akan memberi jawaban atas segala
pertentangan kita untuk melakukan cosmetic surgery, seperti contoh jika kita takut dengan
rasa sakit maka saat ini teknologi sudah canggih, jika kita tdk tau dmna tempat utk operasi
kecantikan media telah menginformasikan mengenai banyaknya tempat untuk melakukan
cosmetic surgery. Keberhasilan media memasuki empat fungsi attitude langsung
berpengaruh terhadap pengambilan keputusan dari seseorang dikarenakan fungsi attitude
adalah helping consumers make decisions about their purchasing practices, and also serve
other functions according to the individual’s circumstances (Solomon 2013)

Meskipun media telah berhasi memasuki keempat fungsi attitude dan

mempengaruhi decision making, muncul pertanyaan apakah hal tersebut mengubah
attitude seseorang mengenai cosmetic surgery? Apakah attitude dapat berubah?
Jawabannya Ya. Berdasarkan teori, attitude ternyata dapat diubah. Menurut Blackwell
(2001) attitude dapat dirubah depends on their resistance. Attitude resistance represents
the degree to which an attitude is immune to change. Some attiude are highly resistant to
change, others are much more reliable. Untuk merubah attitude menurut Blythe (2013)
attitude dapat dirubah melalui : (1) add a new salient brief, (2) change the strength of salien
belief, (3) change the evaluation of salient belief, (4) make an existing brand more salient.
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