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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA. PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION 1. NAME OF THE CANDIDATE AND ADDRESS Santhosh Kumar T 2. NAME OF THE INSTITUTION Smt M.C vasantha College of Nursing Naubad Bidar 3. COURSE OF THE STUDY AND I Year M. Sc (Nursing), SUBJECT Medical Surgical Nursing. 4. DATE OF ADMISSION TO THE COURSE 13/10/2010 5. TITLE OF THE STUDY A STUDY TO ASSESS THE KNOWLEDGE AND ATTITUDE OF STUDENTS FEMALE REGARDING PREVENTION ON EFFECTS OF COSMETIC PROCEDURE ON HEALTH IN A SELECTED SCIENCE COLLEGES, BIDAR WITH A VIEW TO DEVELOP AN SELF-INSTRUCTIONAL MODULE 6.1 INTRODUCTION There is more to beauty than meets the stranger's eye, according to results from three studies examining the influence of non-physical traits on people's perception of physical attractiveness. The results, which show that people perceive physical appeal differently when they look at those they know versus strangers, are published in the recently released March issue of Evolution and Human Behavior. There are facials, manicure, pedicure, hair treatments and makeup that have given a boost to the dream of ultimate beauty.1 Cosmetic procedures are various treatments done in order to restore body part to look normal, or to change the body part to look better. It is a procedure to beautify health and body and include cosmetic enhancements, cosmetic dentistry and cosmetic treatment to improve the appearance. Cosmetic treatments minimizes the signs of aging, reverse sun damage, removes scars and facial hair, reshapes nose and lips, lift breasts, beautifies skin complexion and remove common skin flaws. For cosmetic procedure per capita spent by certain country are Switzerland 214.621 per 100,000 people, United States 30.768 per 100,000 people, United Kingdom 7.723 per100,000 people.2 According to the report in an article, the benefits of cosmetic procedure are fantastic both physically and emotionally. Women will not only look and feel younger, thinner, and prettier, but women’s self-esteem will be similar to skyrocket. Many female college students discover that they are more outgoing, more personable, and more confident. Individuals who undergo cosmetic surgery find themselves emotionally more confident. The benefits of cosmetic procedure far outweigh the risks.3 Any type of cosmetic procedure involves certain common risks like infection, bleeding, and damage to nerves, blood vessels and muscles. Less serious risks comprises of allergic reactions, asymmetry and pain, delayed or prolonged healing of the affected area, acne break outs, scarring, and dissatisfaction with the end result. It's always healthy to get exposed about the pros, cons and risk factors involved with cosmetic surgery. New cosmetic procedure technologies are coming out with the assurance of better results. Some common risks of cosmetic surgery are decrease in BP, infection, loose stitches, asymmetry. 4 According to a report the average women’s morning makeup routine puts them into contact with more than 100 chemicals before breakfast. And many of them are harmful. Face is most important part of a personality which makes person look best, but for some women that’s not so easy because of acne. There are number of medications to control this condition and also there are number of natural alternatives such as neem oil, lavender oil, tea tree oil or thyme oil to combat oily skin and acne with impressive results.5 According to American Society for Aesthetic Plastic Surgery, New York March 16 2009 reports over 10.2 million cosmetic surgical and nonsurgical procedures were performed worldwide 2008, according to statistics released. The top non surgical cosmetic procedures done on women are: Laser hair removal 1,101,255, botox 2,239,024, laser skin surfacing 532,008, chemical Peel 554,492, body thermage 50000, ablative laser procedure 570,000, non ablative laser procedure 467,000.The top surgical cosmetic procedures done on women are: Rhinoplasty 160,283, otoplasty 33,107(2% all procedure), breast augmentation 399,440, eyelid surgery 166,426, lipoplasty 309,692, abdominoplasty 143,005, breast reduction 139,926, dental cosmetic correction 930,250.Almost 92 percent of women undergo 9.3 million of cosmetic procedures in the year 2008.6 According to report given by Indian Aesthetic Society Cosmetic surgery has been practiced in India for a long time but this branch of cosmetic procedure gained considerable importance and popularity in the last 10-12 years. The historical event which leads to this type of procedure are very interesting, According to an article published in The Indian Journal of Post Graduate Medicine, the earliest mention of plastic surgery finds place in the Hindu mythology where Lord Shiva performed the first surgical procedure by attaching an elephant’s head on the body of his son Ashwini Kumar who successfully replanted the severed head of Yagna. Thus, the history of plastic surgery in India dates back before the Vedic times nearly 4000 years ago. Some of the common non surgical cosmetic procedures done on women are: Laser hair removal 110,230, ablative laser procedure 116,324, non ablative laser procedure 176,749, chemical peel 50,653, Laser skin surfacing 160,435, botox 68,345, hair transplant 30,345.Some of the common surgical procedures done on women are: Rhinoplasty 7,864, otoplasty 6,720, breast augmentation 123,600, breast reduction 98,236, eyelid Surgery 87,678, abdominoplasty 80,320, and liposuction 76,560. The Indian aesthetic industry is still in its infancy and with the help of the active institutions in the same field, it needs to build on its image in order to attract more patients for cosmetic surgery.7 According to Bidar statistics of cosmetic procedure, Bidar, one of the fastest growing cosmopolitan cities in Asia also holds the status of being the silicon valley of the east. The major hospitals which will do the cosmetic procedures are Apollo Hospital, Manipal Hospital, Sagar Hospital, and BGS Global Hospital.The main surgeries performed in bidar are: 8,450 Rhinoplasty, 1,289 otoplasty, 54,600 dental cosmetic procedure, 96,695 ablative laser procedure, 69,986 non ablative laser procedure. 8 A Daily Telegraph in London reports a women addicted to cosmetic procedure is unrecognisable after injecting cooking oil into her face. Korean woman Hang Mioku 48yrs, had her first cosmetic surgery procedure at age of 28, become addicted and moved to Japan for more procedures. Eventually surgeons refused to carry out any more work and she returned home, where her face had changed so much her family didn’t recognise her. She soon found a doctor who would give her silicone injections and he even gave her a syringe and silicone so she could self-inject. When her supply ran out, she used cooking oil. Her face became so large compared to her small body that local children called her “standing fan”, the newspaper reported. The first of several operations removed 60g of oil from her face and 200g from her neck. Her face has been left scarred and disfigured, and Ms Hang said she would like her old looks back. The author concluded that due to increasing trends, women are not aware about the consequences of procedure. So there is a need in the society to make them aware about the condition.9 With recent increase in popularity of cosmetic procedures, it seems that everyone these days is getting these procedures. As every women want to transform their looks and to look prettiest so they undergo various procedure without noticing its pros and cons. So the investigator felt a need to conduct a study on their knowledge and attitude towards cosmetic procedure. 6.2 NEED FOR THE STUDY In an effort to let the media establish the definition of beauty, individual all somewhere lost their personal definitions of it. A recent paper titled “what is beauty any way”, found that men characterized the beauty of women by her state of being, the two major components of which were stated as health and happiness. No doubt that the majority of individual approve the fallacy of emphasizing appearance and look but the eager to have a beautiful face, body, and physique is so deeply rooted in individual that they find it difficult to disassociate oneself from it.10 Cosmetic procedure offers a chance for people to change their appearance and enhance their self esteem. A change in the appearance of an individual would mean a change in one’s personality would lead to success in one’s life or career. Cosmetic surgery makes not only to look better, but also to feel better.11 According to newsletter, it reports that More than 55 million cosmetic surgery procedures will be performed in 2015, and states that this will increase consumer awareness, marketing and advertising as well as technological advances in cosmetic procedures.12 The cosmetic procedure institute offers a unique option to enhance persons look, sensuality, and physical appeal and build self confidence. Women will be more outgoing, presentable and confident when they become accustomed to the transformation and this heightened sense of self esteem. The main reason behind the boom in cosmetic procedure is that appearance is important in today's world-not just for what others think of our self, but for one’s self-esteem. Study after study shows that people are most attracted to faces and bodies that are the most symmetrical and proportional. Cosmetic procedure can provide what mother nature has not.13 Cosmetic procedure can help to look attractive and younger. Research over last 25 years has consistently demonstrated the importance of physical appearance in daily life. People who are considered physically attractive are consistently judged more positively. They also receive preferential treatment in various situations like employment, marriage.14 According to the report submitted in a newsletter, with recent increase in popularity of cosmetic procedure, it seems that everyone these days is undergoing cosmetic procedure. The most popular procedures are acne scar treatment, laser procedures, IPL hair removal, rhinoplasty, and liposuction. All of these procedures seek to create a better look for the patient, as well as conforming to society's standards. There's a risk of a reaction to the anesthesia, chance for infection, other post-surgery complications. 15 According to a reports, there are certain myths associated with cosmetic procedure such as the majority of people who decide to undergo cosmetic medical procedures are rich people and celebrities, cosmetic procedure leaves no scars, the results of a cosmetic procedure do not last, laser hair removal is permanent, it is possible to remove stretch marks with laser which has influenced a lot in women to undergo this types of procedures without peeping on the reality.16 A descriptive study was conducted on mothers, fathers and friends about their attitude predict college women’s attitudes about cosmetic procedure . The study found that the vast majority of those who undergo cosmetic surgery are women. They examined their acceptance and desire to undergo cosmetic procedures, attitudes of mothers, fathers, and friends, awareness and internalization of sociocultural appearance messages. Paternal attitudes positively predicted acceptance of cosmetic procedure for social reasons and desire for cosmetic surgery. The study concluded that there is increased acceptance of cosmetic procedure in this society.17 Beauty lies in the eyes of the beholder as the saying goes. So cosmetic procedure gives women the chance to improve on or correct any imperfections thereby achieving an improved overall appearance. It should be understood that in most instances the goal is to improve the clients sense of well being while respecting and preserving her unique attributes. Combined with proper nutrition and exercise, an aesthetic procedure may help to look good, feel better about the way the person look and improve overall self image. But the thing is that one should have a proper knowledge about various streams in this field. 18 The investigator has a personal experience about effects of cosmetic procedure on women while working in dermatology cum plastic surgery ward. The investigator came across a patient who is under the treatment for acne breakouts and scarring due to her passion towards cosmetic procedures. The client had undergone seven times of peeling of acne which leads to scarring. Since there is a widespread misconception related to cosmetic procedure the investigator felt a need to check the attitude and knowledge of the female students regarding cosmetic procedure. 6.3 STATEMENT OF THE PROBLEM A Study to Assess The Knowledge And Attitude of Female Students Regarding Prevention on effects of Cosmetic Procedure on Health in a Selected Science Colleges, Bidar with a view to develop an self-instructional module . 6.4 OBJECTIVES OF THE STUDY 1) To assess the existing knowledge of the female student regarding effects cosmetic procedure on health. 2) To assess the attitude of the female student regarding effects of cosmetic procedure on health. 3) To associate the knowledge and attitude of the female student regarding the effects of cosmetic procedure on health with selected demographic variable. 6.5 OPERATIONAL DEFINITION 1. KNOWLEDGE: It refers to the awareness and understanding of the female student regarding effects of cosmetic procedure on health such as indication, types of procedure, advantages, disadvantages and complications elicited with the help of questionnaire. 2. ATTITUDE: It refers to opinions, values or feelings expressed by the female student towards the effects of cosmetic procedure on health such as indications, misconceptions, benefits, risks as elicited by three point likert scale. 3. FEMALE STUDENT: It refers to female attending the degree or post graduate degree course who are within the age limit of 18-25yrs. 4. EFFECTS: It refers to the benefits like enhancement of look, sensuality, physical appeal and self confidence, risks like pain, allergic reactions, scarring, acne breakout and bruising, complications such as infections, bleeding, damage to nerve, blood vessels, and muscles of cosmetic procedure that the college female students are experiencing. 5. COSMETIC PROCEDURE: Beautifying, tending to preserve, restore or confer comeliness to enhance the human form or appearance which includes procedures such as Minor Non Invasive Procedures like acne scar treatment , ablative laser procedure, non ablative laser procedure, IPL (intense pulsed light) hair removal, ophthalmic laser procedure. Major Invasive Procedure like Rhinoplasty(nose reshaping),dental cosmetic corrections. 6. HEALTH: It refers to a general physical, mental, social wellbeing of female college students who undergo some of the major or minor cosmetic procedures. 7. INSTRUCTIONAL MODULE: A self contained instructional unit that includes indications, types of procedure, risks, benefits, complications regarding cosmetic procedure. 6.6 ASSUMPTIONS The study assumes that, 1. Aesthetic obsession has a common place in current society .So, in this era of beauty, most of the college girls get attracted to different levels of cosmetic procedure without having right information about which suits them best. 2. The female student may have favourable attitude but may not have adequate knowledge about risk and benefit of various types of cosmetic procedure. 6.7 HYPOTHESES H1 There is a significant correlation between the knowledge and attitude of the female student regarding effects of cosmetic procedure on health. H2 There is a significant association of knowledge and attitude of the female student regarding effects of cosmetic procedure on health with selected demographic variable. 6.8 REVIEW OF LITERATURE A literature review helps to lay the foundation for a study and also inspires new ideas. The literature review leads the reader through development of knowledge about choosen topic up to the present time to indicate why this current research topic was necessary. A literature review is a body of text that aims to review the critical points of current knowledge on a particular topic. It is also a critical analysis of a segment of a published body of knowledge through summary, classification, and comparison of prior research studies, reviews of literature, and theoretical articles. A correlational study was conducted on 200 female school students about attitudes of cosmetic procedure. The study concluded two third of the respondents knew someone who had undergone cosmetic surgery, only one third would choose it for themselves. The most desired procedure was liposuction, Rhinoplasty, acne scar treatment, laser procedures, laser hair removal. They have the favourable attitude but lack sufficient knowledge about pros and cons of procedure. They concluded that main reasons for not proceeding were health risk, cost and fear of a bad result.19 A descriptive study was conducted on 250 women about general knowledge of adult in cosmetic procedure in an urban community. Many adult think they have to undergo this procedure once but due to certain misconception like it will alter image, produce scar make them to suppress their feeling. Being knowledgeable with the procedure will enlighten them to do the procedure. 20 A questionnaire based study was conducted on female IT professional regarding knowledge and perceptions of facial cosmetic procedure among a selected group of IT professionals in Lagos, Nigeria. A well-structured questionnaire was administered to a group of professionals. A total of 130 respondents participated in the study of these, 102 (78.5%) respondents had some knowledge of cosmetic procedure while 28 (21.5%) respondents had no prior knowledge of facial cosmetic procedure. Respondents with perceived facial abnormalities were more likely do cosmetic procedure than those without. Conclude that most of the study participants had some knowledge of facial plastic surgery however, only a few expressed willingness to undergo cosmetic procedure for removal of facial wrinkles and folds, fat on the cheeks and neck.21 A descriptive Study was conducted on 101 female school students about teenagers perception of body image and Cosmetic procedure. One of the concerns about cosmetic procedure on adolescents is that their bodies are still maturing. Cultural phenomena such as surgical makeovers on numerous television programs, however, make it increasingly difficult to agree on what constitutes a “normal” appearance. They consider that their body image will alter due to such procedures. About 66% want to have it but are feared due to lack of knowledge .22 A survey was conducted on 130 women regarding misconception about cosmetic procedure which leads to emotional risks The abstract states cosmetic surgery as a physically risky, but overall worthwhile. Options are explained, for improving physical appearance and emotional health issues such as anxiety and depression. So there may arise an increase in women who undergo physically successful cosmetic surgery, regardless of their pre operative emotional state.23 An investigatory study was conducted on 250 female college students regarding experiences, attitudes, and body image after cosmetic procedure. Overall, participants held relatively favorable attitudes about surgery. Regression analysis suggested that a greater psychological investment in physical appearance and greater internalization of mass media images of beauty predicted more favorable attitudes toward cosmetic surgery.24 A cross sectional study was conducted on 150 women regarding relation between reality TV viewership and cosmetic procedure. The study concluded that due to great obsession in mass medias about various cosmetics, procedures women shows significantly favorable cosmetic surgery attitudes, perceived pressure to have cosmetic surgery, a decreased fear of surgery, as well as overall body dissatisfaction, and disordered eating.25 A descriptive study was conducted on 200 housewives about motivating factors for seeking cosmetic procedure. The fascination in physical beauty is becoming more and more prevalent in today's society. The purpose was to ascertain those factors that influence or motivate women to seek cosmetic surgery. The study concluded about 75% of housewives is willing to do procedure and they are mainly motivated due to media advertisement.26 A descriptive study was conducted 100 women regarding young women’s interest in obtaining cosmetic procedure in urban community. This study examined the predictors of young women’s interest in obtaining cosmetic surgery and found that body dissatisfaction mediated the relations between weight statuses, community image and thus increased their attitude towards such procedures to find a place in society.27 A Correlational study was conducted on women and female college students regarding acceptance of cosmetic procedure in urban community and college. This study examined the association between several attitudinal constructs related to acceptance of cosmetic procedure, and participant demographics, personality, and individual difference variables. This revealed that age, sex will generally associated with acceptance of cosmetic surgery. About 44.5% of women show less attitude whereas 68% of college students are interested in cosmetic procedure .28 A descriptive study was conducted on 150 adolescent girls about their perception of cosmetic procedure as a form of self-improvement. The pursuit of beauty through alteration of physical appearance is a growing trend. The adolescent perceive aesthetic procedure as a way to improve their self image and to find a best place in society.29 A survey was conducted to record about number of patients seeking laser treatments. New trends reveal that laser technology is steering the future of the cosmetic surgery industry. Over the past three years, cosmetic surgeons have seen a significant increase in both males (456%) and females (215%) electing to have laser resurfacing. Laser resurfacing is performed with a "super-pulsed" carbon dioxide (CO2) laser to minimize wrinkles and lines on the face. Over the past year, cosmetic surgeons have seen a 29% increase in their female clientele.30 An article was submitted on demand for minimally invasive cosmetic procedures which h reveals that consumer demand for minimally invasive plastic surgery increased 41% in 2003, resulting in more than 6.9 million procedures being performed in that year, according to a March 8, 2004, news release from the American Society of Plastic Surgeons (ASPS). The public has become more aware of treatments such as botulinum toxin type A and hyaluronic acid (ie, Restylane) because of the media attention they have received.31 7 MATERIALS AND METHODS 7.1 SOURCE OF DATA The female student who is attending degree or post Graduate degree courses within the age limit of 18-25yrs in a selected Art’s college, Bidar. 7.2METHOD OF DATA COLLECTION I. RESEARCH DESIGN Research Design used in this study was Non Experimental, Descriptive Correlational Design. II. RESEARCH VARIABLES 1. Study Variable: Knowledge and attitude of the female student regarding effects of cosmetic procedure on health. 2. Demographic Variable: The demographic variables of the female student such as age, religion, family income, education (degree/post degree, name of the degree, year), residential area(rural/urban), previous history of any major cosmetic procedure, previous exposure to information. III. SETTING The setting will be selected BLD Science college, Bidar IV. POPULATION In this study target population are female student aged 18-25yr who are attending degree/post graduate degree course in selected Science college,Bidar. V. SAMPLE Female student aged 18-25yr, who is fulfilling the inclusion criteria will be the sample. Sample size will be 60 VI. CRITERIA FOR SAMPLE SELECTION INCLUSION CRITERIA 1. Female student who are undergoing degree/post graduate degree courses attending a selected Science college, Bidar 2. Female students within the age group of 18-25yrs. 3. Female students, who are able to read, write and understand English or Kannada. EXCLUSION CRITERIA 1. Female students who are not willing to participate. 2. Female students who are absent at the time of data collection. VII. SAMPLING TECHNIQUE Sampling technique used in this study is Probability Sampling in that Stratified Random Sampling Technique is used to select the sections and then using Lottery Method, subjects will be selected from each section . VIII. TOOLS FOR DATA COLLECTION Section A:. A self administered questionnaire to assess the demographic data[age, religion, family income, education (degree/post graduate degree, name of the course, year), residential area(rural, urban), previous history of any major cosmetic procedure, previous exposure to information Section B: A self administered questionnaire to assess the knowledge of the female student regarding effects of cosmetic procedure on health. Section C: Three point Likert scale to assess the attitude of the female student regarding effects of cosmetic procedure on health. IX. METHOD OF DATA COLLECTION After obtaining the permission from concerned authority and getting informed consent from samples, assuring about the confidentiality of information, the investigator will administer the self-administered questionnaire to assess demographic variable, knowledge and three point likert scale to assess the attitude of the female student regarding effects of cosmetic procedure on health. X. PLAN FOR DATA ANALYSIS The data collected will be analyzed using descriptive and inferential statistics. Descriptive Statistics Frequency, percentage Distribution, Mean, Standard Deviation will be used to assess the knowledge and attitude of the female student regarding effects of cosmetic procedure on health. Inferential Statistics 1. Correlation Coefficient Test will be used to determine the correlation between knowledge and attitude. 2. Chi- Square Test will be used to determine the association of knowledge and attitude with selected demographic variable. XI. PROJECTED OUTCOME The investigator will be able to identify existing knowledge and attitude regarding effects of cosmetic procedure on health among female student. Based on the findings the investigator will prepare instructional module about the indication, types of procedure, preparation for procedure, advantages, disadvantages and complications of cosmetic procedure which will help to improve the knowledge and attitude regarding effects of cosmetic procedure on health. 8. LIST OF REFERENCES 1. http://www.beachpsych.com/pages/cc95.html 2. Jacob Christiana. Cosmetic Treatments. Available from http://sitagita.com/beauty/cosmetic-tratement. 3. The cosmetic procedure prices. Available from http://www.cosmeticfinance.com 4. College student and cosmetic surgery. Available from http://www.stateuniversity.com 5. Natalia Kita, George Greyman, Walkin Hofmann. Your face is very important Medical Journal. 2008 Jul 2; 33(1):621-630 6. The cosmetic procedure statistics. Available from http://ASAPS.in 7. Karlin Minte, Jony Williams, Mcboard Gambly. The age old practice of cosmetic procedure. Indian journal of post graduate medicine. 2008 Aug 30; 21l(24):34-36 8. Cosmetic procedure in bidar. Available from http://www.beautycosmetics.com 9. Machlean Dawnel. Cosmetic surgery addict injected cooking oil into her face. The Daily telegraph. 2008 Nov 12; 33(2):236-240 10. Dickens Bowman, Diana George. Body image and cosmetic procedure. American journal. 2009 Jul 26; 12(7): 721-730 11. David J Castle, Riteesh Bookum. Attitude towards cosmetic procedure among university students. Science journal. 2009 Oct 13; 11(4):187-190 12. William Victor. More than 55 million cosmetic procedure will be performed in 2015.Science Daily. 2009 Jun 25; 65(10):660-670 13. Risk in cosmetic procedure. Available from http://beauty.indobase.com/cosmetic 14. Santina John. Cosmetic procedure and appearance. Medical journal. 2008 Jun 30;54(2):373-380 15. Benefits and risks of cosmetic procedure. Available from http://www.beautybenefits.com 16. Aims of cosmetic procedure. Available from http://www.cosmeticprocedureappearance.com 17. Donna Henderson, Kelly D Brooks, Adrienne Adams, Eaaron Henderson. Sociocultural appearance and maternal and paternal attitude predicts college women’s attitude about cosmetic procedure. Interscience Wiley journal. 2008 Oct 24; 6(26):610-620 18. Francis John. Cosmetics and beauty. Available from http://www.beautylines.com 19. Pearl Anne, Weston Jane. Attitude of adolescent about cosmetic procedure to understand their belief. Annuals of plastic surgery. 2009 Jun 16; 90(20): 22 26 20. Dr. Kanodia. General knowledge of adult in cosmetic procedure. Plastic surgery Journal. 2008 Jul 27; 58(5):28-31 21. WL Adeyemo, BO Bamgbose. Knowledge and perceptions of facial cosmetic procedure among a selected group of IT professional in Lagos, Nigeria. The Science Journal. March 9 2009; 8(8):213-215 22. Diana Zukerman. Teenager perception of body image and cosmetic procedure. Online ethics journal of the American medical association. 2008 Mar 21;43(13):355360 23. Christiana Fernandez . Women’s Mags downplay emotional risk of cosmetic procedure. Women’s Magazine. 2008 Dec 12; 21(34):32-35 24. Sarwer DB, Cash TF, William EF. Female college students and cosmetic procedure , an investigation of experiences, attitudes, and body image”. The health magazine. 2008 Dec 6; 31(6):67-70 25. Sperry S, Thompson JK. Cosmetic surgery reality TV viewership, relations with cosmetic procedure attitudes, body image and disordered eating. Journal of cosmetic Procedure. 2008 Oct 28; 2(9):26-30 26. Haas CF, Champion A. Motivating factor for seeking cosmetic procedure, a synthesis of the literature. Journal of cosmetic science. 2008 Nov 18; 9(50):221-223 27. Charlotte N Markey. Young women’s interest in obtaining cosmetic surgery. Journal Springer. 2009 Aug 16 ;31(61):3-4 28. Viren Swami, Thomas Chamorro. Acceptance of cosmetic procedure, Personality and individual difference predictors. Journal of Health. 2009 Apr 6; 51(6):5-7 29. G Terence Wilson, Richard Ashmore. Cosmetic procedure, a common and accepted form of self improvement.Journal Health Science. 2009 Jul 6; 6(3):40-42 30. Jackson Cribites. Record number of patients seek laser treatment to take years off their faces. Science daily. 2009 Mar 24; 80(17): 28-30 31. Elizabeth John. Demand for minimally invasive cosmetic procedures rises. AORN journal. 2009 May 1; 23(40): 221-230 9. SIGNITURE OF THE CANDIDATE 10. REMARKS OF THE GUIDE 11. NAME AND DESIGNATION OF PRINCIPAL (IN BLOCK LETTERS) 11.1 GUIDE 11.2 SIGNITURE 11.3 CO GUIDE (IF ANY) 11.4 SIGNITURE 11.5 HEAD OF THE DEPARTMENT 11.6 SIGNITURE 12 REMARKS OF PRINCIPAL 12.2 SIGNITURE THE CHAIRMAN AND