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"Within the past decade, Asian economies have grown exponentially, resulting in increased personal wealth and subsequent consumption of cosmetic procedures" (Kwak, 2010, p. 102). Facial cosmetic surgeries, including rhinoplasty and eyelid surgery, are among the most common cosmetic surgery procedures requested by Asian patients (Macer 2012; Wong 2009). This phenomenon may be attributed to a "growing social pressure for Asian women to align with 'Western' physical characteristics." (Aquino & Steinkamp, 2016, p.431).Few studies have investigated cosmetic surgery and cosmetic surgery attitudes in young people in Association of Southeast Asian Nations (ASEAN) (Intasoon, n.d.; Ng, Yeak, Phoon & Lo, 2014; Swami, 2010). In a study among university students in Singapore, 2.8% and in Bangladesh, 8.6% admitted to having undergone cosmetic procedures (Ng et al., 2010; Pengpid, Peltzer & Ahsan, 2015). Among female Saudi university students, 2.2% had received cosmetic surgery (Al-Saiari & Bakarman, 2015), while among American female undergraduate students 3% to 5% had undergone cosmetic surgery themselves (Delinsky, 2006; Sarwer et al., 2005). Previous studies among university students found that 16.2% of female Saudis (Al-Saiari & Bakarman, 2015) and 40% among female Americans (Sarwer et al., 2005) would consider having cosmetic surgery.In a study among university students in Colombia a mean "Acceptance of Cosmetic Surgery Scale (ACSS) Consideration" was 4.17 (range 1-7) and in USA 3.19 (Carrion, Weinberger-Litman, Rabin & Fogel, 2011b). The mean ACSS subscales Social and Intrapersonal were in Colombia 3.46 and 3.89, respectively and in USA 2.32 and 4.02, respectively (Carrion et al., 2011b). Further, in a study among British female university students the ACSS Consideration was 4.86 for Caucasian, 3.75 for Asian and 3.64 for African Caribbean students (Swami, Campana & Coles, 2012a).Factors associated with cosmetic surgery consideration include 1) sociodemographic factors such as being a woman (Swami, Hwang & Jung, 2012b) and lower socioeconomic status (Jackson & Chen, 2015; Javo & Sorlie, 2010); 2) body related factors, lower Body Mass Index (BMI) (Swami, 2009), higher BMI (Carrion, Rabin, Weinberger-Litman & Fogel, 2011a); less body appreciation (Swami, 2009), poor body image (Javo & Sorlie, 2010; von Soest, Kvalem, Skolleborg & Roald, 2006), general body appreciation (Swami et al., 2012b), facial appearance concerns (Jackson & Chen, 2015), and internalization of thin ideals (Nerini, Matera & Stefanile, 2014); 3) social variables such as religiousness, low self-esteem (Fumham & Levitas, 2012), lack of life satisfaction (Intasoon, n.d.), and personality factors, including low selfesteem (Swami, Chamorro-Premuzic, Bridges & Furnham, 2009), and 4) mental health issues such as body dysmorphic disorder symptoms (Haas, Champion & Secor, 2008; Javo & Sorlie, 2010) and eating disorder attitudes (Carrion et al., 2011a; Pengpid et al., 2015).The aim of the study was investigate male and female university students' experiences and attitudes about cosmetic surgery in five ASEAN countries.MethodsSample and procedureIn a cross-sectional study randomly selected university students in five ASEAN countries responded to a questionnaire on various health behaviours and cosmetic surgery attitudes in 2015. Informed consent was taken from participating students. Participation rates were in three countries more than 90%, in Indonesia 69% and in Myanmar 73%. Ethics approvals were obtained from all participating study institutions.MeasuresCosmetic surgery experience. Students were asked, If they ever had any cosmetic surgery (response options: yes or no), and which cosmetic surgery procedures they would consider undergoing in the future.Attitudes towards cosmetic surgery were assessed with the 15-item "Acceptance of Cosmetic Surgery Scale" (ACSS; Henderson-King & Henderson-King, 2005), which has three different 5-item subscales. …

Cosmetic surgery consideration among male and female university students in five ASEAN countries