TV News Coverage of Plastic Surgery, 1972-2004
Cho, Sooyoung, Journalism and Mass Communication Quarterly
TV NEWS COVERAGE OF PLASTIC SURGERY, 1972-2004
This study content analyzed all of the 265 news story abstracts on various types of plastic surgery from the five major TV networks during the past three decades. Coverage increased during the time periods, concentrating in the 1990s when public health controversy about breast implants erupted. Overall, TV network news coverage was most concerned with the issue of safety and health risk and framed coverage with an emphasis on risk. Unlike traditional health reporting, which relies mostly on doctors in the field, news coverage about plastic surgery extensively used experts from other fields.
Most Americans today are generally familiar with plastic surgery. It has become a popular social phenomenon. According to the American Society of Aesthetic Plastic Surgery (ASAPS), nearly 8.4 million surgical and non-surgical procedures were performed in 2003. Eighty-seven percent of patients getting these procedures in 2003 were women and 13% were men.1 These statistics show an increase of 16% for women and 12% for men over 2002 figures. Clearly a growing number of people are interested in the possibility of plastic surgery. Furthermore, television reality shows like Fox's The Swan and ABC's Extreme Makeover have presented extreme plastic surgery cases, physically transforming ordinary people. Such TV programs may be a factor influencing people's decisions to pursue such an operation.
TV news is a primary source of health information and has the power to raise initial public awareness about a health issue.2 In addition, plastic surgery stories on TV news, because of its broad reach of various kinds of audiences, can heighten awareness not only for people considering operations, but also for their family members. In this regard, TV news is an important informational conduit about plastic surgery, and its selection of and emphasis on certain aspects is important to the public.3
Despite growing interest among Americans, few studies (and none for TV) have investigated news coverage of plastic surgery, such as issues, types of operations, and controversies. The purpose of this study was to examine and compare (1) the number of news reports devoted to plastic surgery over the last thirty years; (2) the types of cosmetic operations described; (3) the types of issues covered and frames used; and (4) the types of sources. This study describes and examines the news reporting patterns of this popular medical and social phenomenon over four time frames-the 1970s, 1980s, 1990s, and 2000-2004.
Media and Plastic Surgery. Mass media's influence on women's body images has been well documented. Often, entertainment and thinideal media content is blamed as one of the factors responsible for promoting a distorted body image. Pipher blames the media for exalting thinness and contributing to higher rates of body dissatisfaction in young girls and women.4 Some studies found that media exposure and reading of women's fitness magazines promoted eating disorders and feelings of body dissatisfaction among women.5 This suggests that exposure to TDP (thinness depicting and promoting) media could damage many women's self- and body image.
In addition, television programs and fashion magazines appear to encourage the idea that women must be thin to be happy, popular, and successful.6 For example, primetime television programs often portray thin female characters as successful and as the object of desire by others, whereas overweight female characters receive negative comments from male characters.7 Conducting a focus group and interviews with two generations of Hispanic women about magazine use and their body image as compared to magazine depictions, Pompper and Koenig found that women of both generations emphasized the importance of personal appearance in competing for employment, which will determine their socio-economic status.8
Influenced by a social environment that emphasizes physical appearance, increasing numbers of women as well as men are attracted to the possibility of some type of plastic surgery.9 Although the literature about media effects on women's body image is extensive, and despite the growing popularity and interest in plastic surgery, few studies have examined media portrayals of plastic surgery. Because the number of people receiving these operations has increased, the amount of news coverage regarding various types of plastic surgeries should, logically, also have increased. As the literature on media influence on women's body image perceptions suggests, mass media also might have an influence on their decisions to pursue plastic surgery. If so, the media's selection and framing of issues within plastic surgery coverage is important, especially for the most frequently cited source of health information, TV news.10
Framing Plastic Surgery. News framing concerns the selection and emphasis of certain aspects of issues.11 By selecting and highlighting certain aspects while excluding other information, journalists can influence public opinion and audience interpretation of issues.12 Research has shown that media frames impact public understanding and can alter public opinion on ambivalent and controversial issues.13 For example, a study found that people expressed greater tolerance when a Ku Klux Klan rally was framed as an exercise of free speech than as a disruption of social mores.14 In a similar vein, TV news emphasis of certain aspects of plastic surgery could influence people's opinion toward such surgery and some people's consideration of getting this surgery.
No quantitative studies have examined news coverage of plastic surgery. Researchers have examined how issues in health news are framed using content analysis. For example, analyzing newspaper cancer coverage, Freimuth et al. found that "causes of cancer," "celebrities," and "therapy" were the three major cancer topics.15 Examining coverage about the breast implants controversy in major newspapers, Powers and Andsager identified six key issues in pretesting the data.16 One of the issues in their study was health risks related to breast implants.
As suggested in the Powers and Andsager study, safety and health risk should be one of the major issues in plastic surgery reporting because of adverse incidents related to plastic surgery or associated procedures. For example, four people who received low-cost Botox shots at a Florida clinic in 2004 suffered serious injury including botulism and paralysis.17 In the 1990s, a public health controversy regarding silicone gel breast implants was a prominent issue. After a November 1991 story on CBS's Face to Face reported severe health problems associated with breast implants,18 the public became aware of potential complications involved with this procedure. In covering this procedure, the media have reported lawsuits, policies/FDA rules, and possible links to other diseases.
Celebrities and other famous people also appear to play an important role in general health news reporting. Indeed, according to research on cancer reporting, famous people was one of the major issue categories.19 Based on previous research, it seems likely also that another issue in plastic surgery coverage would be economic interests and concerns related to the marketing of plastic surgery.
Issue categories established in previous studies20 served as a basis for this study. Because this research topic is different from research on general health or disease reporting, a constant comparative method, employed in qualitative analysis,21 was used to develop the issue coding categories appropriate for the topic.
Another way of examining news frames of plastic surgery stories would be to look at whether the story focused on beneficial aspects of plastic surgery or negative/risk aspects of it. Plastic surgeons and relevant manufacturers naturally emphasize beneficial aspects of plastic surgery. According to Zimmerman, one-third of women in her study who received breast implants reported that doctors promised higher self-esteem and assured them that the surgery was virtually risk free.22 When the breast implant controversy broke in the 1990s, the manufacturer launched a media campaign targeting major news organizations, emphasizing that implants are safe and that women had a right to make their own informed decisions.23 Powers and Andsager found that the health risks of silicone breast implants received much less coverage after the media campaign by the manufacturer, while health risks were the prominent concern of the news coverage before the campaign.24
Although many plastic surgeons may tend to downplay the dangers of cosmetic surgery, incidents such as the silicone breast implant health problems and recent Botox-related botulism cases highlight the medical danger and uncertainty surrounding cosmetic procedures. Zimmerman noted that women are misinformed about the risks of breast implants, and adverse post-implant experiences are minimized and trivialized.25 The present study may find that news coverage emphasized the positive aspects of plastic surgery, its negative aspects, or some balance in between. As Powers and Andsager's study of breast implants showed, news media-if influenced by aggressive advertising/PR efforts of plastic surgeons and manufacturers highlighting the positive aspects of plastic surgery-may have focused on the beneficial aspects of plastic surgery, spotlighting successful surgery cases and patient satisfaction. Conversely, news media may have been focused on risk/negative aspects of plastic surgery, emphasizing its dangers and side effects.
Sources. Sources have enormous power to shape news stories. Journalists establish certain media frames through dialogue with their sources. Entman noted that media frames emerge as journalists emphasize certain sources.26 In this sense, sources play an important role in the framing of news.
Reporters often depend on experts for their stories, including health reporting. According to Corbett and Mori, medical reporters often refer to medical journal articles and rely on medical professionals.27 Due to its technical nature, medical news information originates largely with medical doctors and researchers.28 For example, approximately half of the sources for breast cancer TV coverage were medical doctors in the field.29
Professional sources can be effective in enhancing the credibility of news stories, but when they dominate health news stories, such sources may represent a one-sided perspective that hinders further investigation.30 A dominant group of sources, such as would be the case with a heavy reliance on medical professionals in a field, could create a self-serving bias and influence news stories toward one-way information flow and publicity. Analyzing breast implant articles that appeared in the New York Times between 1991 and 1993, Darling-Wolf found that only thirteen women who had implants were interviewed.31 Because plastic surgery is a somewhat controversial part of medicine, a positive step would be use of diverse sources from other medical fields in addition to plastic surgery, as well as people who had this surgery. Because source use is another important aspect of framing news, this study will look at types of sources used in TV news plastic surgery reporting over the decades.
RQ1: Has the number of TV news reports about plastic surgery increased over time?
RQ2: What are the frequently covered cosmetic operations in TV news coverage of plastic and over time? surgery by each decade
RQ3: Has the proportion of issues in TV news coverage of plastic surgery changed over time?
RQ4: Overall, did TV news emphasize beneficial aspects (promote and positively describe the surgery) or risk aspects (discourage and negatively describe the surgery) of plastic surgery?
RQ5: Are there changes in the types of sources used in TV news about plastic surgery over time?
RQ6: Which source is used most for each surgery type?
Sampling Procedure. The study used a census of news abstracts. All evening news abstracts on various plastic surgeries that appeared on ABQ CBS, NBQ Fox, and CNN from 1972 through 2004 were collected from the Vanderbilt TV Archives at http://tvnews.vanderbilt.edu. Abstracts may not be the ideal choice of material to examine news frames, but because the purpose of the study is to examine and compare TV news reporting on various plastic surgeries during a thirty-year time span, the researcher used abstracts. Vanderbilt Archives indexes broadcast news abstracts on plastic surgery back to 1972 and allowed the researcher to examine trends in TV news coverage over the time periods, whereas Lexis Nexis, a source of TV news transcripts, goes back only to 1980 for ABC, 1990 for CBS, and 1997 for NBC, and thus precludes accessing earlier years' transcripts. The abstracts from the two cable newscasts, CNN and Fox, started from 1995. To ensure the validity of the abstracts in representing the content of the news stories, 30 abstracts were randomly selected and were compared with the same 30 TV transcripts obtained from Lexis Nexis based on coding categories.32
Using key terms such as "plastic surgery," "cosmetic surgery," "plastic surgeon," "Botox," "breast implants," "facelift," and "liposuction,"33 a total of 328 abstracts were retrieved in the initial search spanning the period beginning in 1972 and ending in 2004. After eliminating overlapping abstracts and screening and discarding non-plastic surgery coverage, a total of 265 abstracts were examined for the final analysis.
Coding Categories. An abstract was used as the coding unit for all categories. First, to see whether the number of news reports about plastic surgery has increased over the time period, the number of news abstracts in each year was calculated. The number of abstracts from the three networks was combined over the years (see Table 1). Adding the reports from Fox and CNN with the three broadcast networks would create a distortion in the data because these two TV stations were established later. Therefore, the news reports from Fox and CNN were analyzed separately from the broadcast networks.
Second, pretesting identified seven types of plastic surgery. These categories include: (1) plastic surgery in general, which is not specified; (2) breast implants; (3) Botox; (4) liposuction; (5) facelift surgery and profile modification, such as nose jobs and eyelid surgery; (6) reconstructive surgeries, such as for birth defects, accidents, after-breast-cancer surgery, and face implants (all generally defined as medically necessary procedures); and (7) others, such as laser surgery and injection shots to reduce fat.
Third, the researcher developed issue categories using the constant comparative method. To accomplish this, the researcher first set several provisional issue categories based on the previous health news content analysis studies. Then, initially coded abstracts were put into a set of provisional categories and each new abstract was compared to those already assigned to that category. Finally, new categories were created if abstracts did not fit any preexisting category. The eight issue categories developed include (1) popularity of plastic surgery, such as people's obsession with looking young and decisions to have surgery; (2) safety and risk issues relating to surgery, such as related death, side-effects, and problems of bad/non-certified doctors; (3) links to other diseases, such as breast cancer; (4) litigation/lawsuits; (5) policies about plastic surgery, such as an PDA rules ban on silicone breast implants and a proposed law which would allow oral surgeons to perform facial plastic surgery; (6) descriptions of general and new plastic surgery procedures; (7) celebrities/famous people who got plastic surgery; and (8) miscellaneous, such as credit financing of plastic surgery procedures.
Fourth, each abstract was examined in terms of its benefit-risk frame aspect. When a report emphasized patients' satisfaction and improved self-esteem after the surgery, it was coded as a benefit-focused frame. When an abstract emphasized side effects from surgery, including death related to the surgery, it was coded as a negative/risk-focused frame. When an abstract contained both benefit and risk aspects, it was coded as neutral. Finally, when an abstract did not report either a benefit or a risk aspect, it was coded as not identified.
Lastly, source categories include (1) plastic surgeons; (2) experts from other fields, such as economists, and from other medically related fields, such as bioethicists; (3) patients and their families, including celebrities who received plastic surgery operations; (4) spokespersons of hospitals and Dow Corning; (5) activists and consumer groups; (6) policy makers, such as members of Congress and other government officials who have power to influence health legislation or policy; and (7) other, which includes attorneys, producers of TV shows, and unspecified sources. A source was defined as any person who was interviewed in the story. In the abstract, a source's comments were marked within brackets with his / her job title and the researcher considered as a source only someone mentioned within the brackets. When the same source appeared several times in the abstract, it was coded once.
Intercoder Reliability. The author and a graduate assistant coded the materials. Using Cohen's kappa, which controls for agreement by chance, intercoder reliability was .95 for types of plastic surgery; .81 for types of issues; .91 for source types; and .91 for benefit/risk frame types. Landis and Koch state that values of kappa from 0.81 to 1.0 indicate acceptable inter-coder reliability.34 Therefore, the data were sufficiently reliable for analysis.
Of the 265 TV news abstracts, 76 abstracts were from ABC, 91 from CBS, 70 from NBC, 20 from CNN, and 8 from FOX. RQ1 examined whether TV news reports on plastic surgery have increased over time. As Table 1 shows, the number of reports on plastic surgery increased over the decades and dramatically increased during the 1990s. Notably, news reports increased rapidly in 1991, peaked in 1992, and increased rapidly again in 1994. The last five years (2000-2004) also showed a gradual growth in numbers.
RQ2 (Table 2) examined the frequently covered cosmetic operations in each time period and overall. Overall, breast implants received the most media attention (161, 60.8%), followed by plastic surgery in general (46, 17.4%). More specifically, facelift/profile modification (6, 54.5%) was the most frequently covered operation in the 1970s. Plastic surgery in general, non-specific operations (4, 28.6%), and breast implants (144, 77.4%) were the most prominently covered operations in the 1980s and 1990s, respectively. In the last five years, 2000-2004, Botox (16, 29.6%) received the most media attention, followed by breast implants (15, 27.8%).
RQ3 investigated the key issues in each time period and whether the proportion of coverage that each issue received changed over the periods (see Table 3). Among the eight issue categories, overall, safety and risk issues (75, 28.3%) received the most media attention, followed by litigation/lawsuits (66, 24.9%), and policy/PDA rules (32, 12.1%). The top two key issues identified in the 1970s were celebrity (5, 45.5%) and safety and risk (2,18.2%); in the 1980s, safety and risk (5, 35.7%) and other (4, 28.6%); in the 1990s, litigation/lawsuits (64, 34.4%) and safety and risk (52, 28%); and 2000-2004, safety and risk (16, 29.6%) and policy/PDA rules (14,25.9%). The study also looked at whether the proportion of coverage that each issue received has changed. Overall, the celebrity/famous people issue showed a gradual decrease, while issues of policy/FDA rules and introducing general and new procedures showed a gradual increase. Issues of safety and risk and popularity of plastic surgery generally showed a constant pattern over time. Litigation/lawsuits received the most coverage during the 1990s.
RQ4 examined whether TV news emphasized benefit or risk frames. Overall, TV news emphasized either risk frames (103, 38.9%) or "not identified" benefit-risk aspects (116, 43.8%) over the years, with fewer than 10% of the reports framing plastic surgery with an emphasis on the benefits of such surgery (23, 8.7%). The neutral category consists of 8.7% (23).
The last two RQs (RQ5 and RQ6) concerned the types of sources. A total of 535 sources were identified. Table 4 indicates that, on the whole, patients were the most frequently interviewed source (164, 30.7%), followed by experts from other fields (135, 25.2%), and plastic surgeons (79, 14.8%). It is interesting that plastic surgeons were used as a source to a lesser degree than experts from other fields, except in the 1980s. Especially during the 1990s, the proportion of plastic surgeons as source suddenly dropped (25.0% to 11.9%), whereas the proportion of experts from other fields doubled from the 1980s (11.1% to 26.4%). Spokespersons of organizations and consumer groups/activists were used to a higher degree, proportionally, during the 1990s as compared to the other time periods.
In addition to examining sources used across the time periods, RQ6 examined the types of sources used in coverage of different operations. One notable finding is that plastic surgeons were used much less in coverage of breast implants (15, 5.4%). Rather, breast implant stories more frequently used as sources experts from other fields (79, 28.3%), patients (72, 25.8%), spokespersons (31, 11.1%), policy makers (21, 7.5%) and activists (16, 5.7%).
Discussion and Implications
This study examined how TV news covered the popular medical trend of plastic surgery over the last three decades. Reflecting the popularity of plastic surgery, TV news coverage showed a gradual increase over the decades. Among eight issue categories developed, safety and risk, litigation/lawsuits, and policy/FD A rules received extensive coverage across the years, although major issues were somewhat different in each time period. In the 1970s, famous people, including politicians and Betty Ford (who had reconstructive cosmetic surgery) received major media attention. Similar to a previous breast cancer study,35 which found celebrities as the major media issue in breast cancer stories in the 1970s, celebrities and their surgeries was the most important category in plastic surgery stories in the 1970s. Celebrities seem to play an important role in health news by drawing public attention to the issue in question.
Safety and risk was the most prominent issue in the 1980s and 2000-2004 periods and the second most prominent issue in the 1990s. The safety and health risk issue regarding silicone gel and saline breast implants, including the alleged malfeasance by implant manufacturers and the health concerns of implant recipients, was a controversial issue from the late 1980s to 1990s, and TV news picked up on this. The safety and health risk issues of breast implants as well as Botox were also major media foci over the last five years (2000-2004). As with health risk and safety concerns, lawsuits filed by women suffering health problems from breast implants and the associated settlement processes received extensive media attention during the 1990s. Additionally, policy/ FDA rules received considerable TV news coverage in the last five years (2000-2004) because, during this period, the FDA recommended ending the ban on silicone breast implants and then later revoked its recommendation.
Issues that received extensive media coverage over the years suggest that TV news framed plastic surgery with an emphasis on negative/risk aspects rather than beneficial aspects. As with Powers and Andsager's finding,36 risk was one of the major issues in this study. Given the increasing numbers and popularity of plastic surgery, the TV news emphasis on risk aspects of plastic surgery could have impact on people's opinions and decision on getting surgeries. While other popular channels such as TDP (thinness depicting and promoting) media and popular plastic surgery reality shows (e.g., The Swan and Extreme Makeover), along with extensive marketing activities by plastic surgeons and manufacturers,37 have promoted the option of plastic surgery without much emphasis on the risks involved,38 TV news may have alarmed audiences by emphasizing safety and risk issues, especially during the breast implants controversy.
In order to examine a more detailed source use pattern, the study differentiated between plastic surgeons and experts of other medical fields and other disciplines. Unlike traditional health reporting, which relies mostly on medical doctors in the field,39 TV news about plastic surgery extensively used experts of other fields rather than just plastic surgeons, especially in covering the breast implant problems. Although reporters still adhere to the conventional use of expert sources in covering plastic surgeries, they seemed to strive to diversify the sources by including expert opinions from other fields. Moreover, although the percentage is not high, activists' opinions were sought in covering breast implants. This suggests that news reporters tried to convey diverse voices rather than exclusively interviewing plastic surgeons, who may be more favorable toward the procedure. TV news also used patients as sources across the time periods, especially in Botox coverage. Source use is another important aspect of framing news. Because of the controversial nature of plastic surgery, diverse opinions from different sources were sought in plastic surgery reporting. Future studies about controversial issues, especially in health reporting, would be needed to confirm the current findings. During the 1990s, many lawsuits were filed, so attorneys were frequently used as sources; they were categorized as "others."
In her book Cosmetic Surgery, Sullivan argued that the plastic surgery trend reflects the increasing commercialization of American medicine. She argued that many of the field's practitioners are driven primarily by a profit motive and treat medicine as a business.40 In an era of extensive medical marketing, plastic surgeons and medical associations are trying to "sell" surgery and related procedures through advertisements and popular/entertainment media, often with seemingly little regard for what may be best for the patient. In this regard, TV news, with its broad audience impact, is responsible for providing information and viewpoints that are different from those in commercial marketing media. Findings of this study showed that TV news framed its reports on safety/risk factors and sought different opinions from diverse sources.
Still, reporters may need to cover plastic surgery with even more serious scrutiny, in the manner of covering other health issues and diseases, not merely treating it as a popular or novel phenomenon. This is urged because more and more Americans are seeking these operations, and some have suffered serious health problems associated with them. In this vein, news media should not shy away from investigating controversial issues associated with plastic surgery, because such issues would be ones that popular media and plastic surgeons avoid due to potential impact on sales.
Suggestion for Future Study. In plastic surgery reporting, visuals may play a more vital role in framing than they would for other topics. This study is limited by not including the visual component of news. Future research could profitably focus on visual elements in plastic surgery reporting. In addition, subsequent media framing effects studies, examining whether differently framed stories or visuals affect people's perceptions towards plastic surgery, will also contribute to this area of research.
1. Ashima Kadyan, "USA: Is the Botox Party Over?" Women's Feature Service, January 31, 2005, http://www.newsnetwork-bd.com/ UI/Public/Feature.php?FeatureCode=239, accessed January 10, 2007.
2. Frank Newport, "Americans Get Plenty of Health News on TV, but Tend Not To Trust It," Princeton, NJ: The Gallup Organization, http://www.gallup.com/content/ default.asp?ci=6883&pg=l, accessed October 15, 2006.
3. "21st Century House Call: The Link between Medicine and the Media," National Health Council, Washington, DC, December 1997; "Americans Talk about Science and Medical News," National Health Council, Washington, DC, December 1997; "News Audiences Increasingly Politicized: Online News Audience Larger, More Diverse," Pew Research Center for the People and the Press, 2004, http://peoplepress.org/reports/display. php3?PageID =834, retrieved November 24, 2006,
4. Mary B. Pipher, Reviving Ophelia: Saving the Selves of Adolescent Girls (NY: Ballantine Books, 1994).
5. Kristen Harrison and Joanne Cantor, "The Relationship between Media Exposure and Eating Disorders," Journal of Communication 47 (winter 1997): 40-67; M. Mitka, "Magazine Ideals Wrong," Journal of American Medical Association 286 (July 2001): 409; Eric Stice, Erika SchupakNeuberg, Heather E. Shaw, and Richard I. Stein, "The Relation of Media Exposure to Eating Disorder Symptomatology: An Examination of Mediating Mechanisms," Journal of Abnormal Psychology 103 (November 1994): 835-60.
6. Amy R. Malkin, Kimberlie Wornian, and Joan C. Chrisler, "Women and Weight: Gendered Messages on Magazine Covers," Sex Roles 40 (April 1999): 647-55.
7. Gregory Fouts and Kimberly Burggraf, "Television Situation Comedies: Female Body Images and Verbal Reinforcements," Sex Roles 40 (April 1999): 473-82.
8. Donnalyn Pompper and Jessica Koenig, "Cross-CulturalGenerational Perceptions of Ideal Body Image: Hispanic Women and Magazine Standards," Journalism & Mass Communication Quarterly 81 (spring 2004): 89-107.
9. Kadyan, "USA: Is the Botox Party Over?"
10. "News Audiences Increasingly Politicized: Online News Audience Larger, More Diverse," Pew Research Center for the People and the Press, 2004, http:/ /people-press, org/reports/display.php3?PageID=834, retrieved November 24, 2006.
11. Amy E. Jasperson, Dhavan V. Shah, Mark Watts, Ronald J. Faber, and David P. Fan, "Framing and the Public Agenda: Media Effects on the Importance of the Federal Budget Deficit," Political Communication 15 (1998): 205-24.
12. Vincent Price and David Tewksbury, "News Values and Public Opinion: A Theoretical Account of Media Priming and Framing," in Progress in Communication Sciences: Advances in Persuasion, ed. George A. Barnett and Franklin J. Boster, vol. 3 (Greenwich, CT: Ablex, 1997): 173212; Fuyuan Shen, "Effects of News Frames and Schemas on Individuals' Issue Interpretations and Attitudes," Journalism & Mass Communication Quarterly 81 (summer 2004): 400-16.
13. David Domke, Dhavan V. Shah, and Daniel B. Wackman, "Media Priming Effects: Accessibility, Associations, and Activation," International Journal of Public Opinion Research 10 (1, 1998): 51-74; Shanto Iyengar, is Anyone Responsible? How Television Frames Political Issues (Chicago: University of Chicago Press, 1991).
14. Thomas E. Nelson, Zoe M. Oxley, and Rosalee A. Clawson, "Toward a Psychology of Framing Effects," Political Behavior 19 (3,1997): 221-46.
15. Vicki S. Freimuth, Rachel H. Greenberg, Jean DeWitt, and Rose Mary Romano, "Covering Cancer: Newspapers and the Public Interest," Journal of Communication 34 (winter 1984): 62-73.
16. Angela Powers and Julie L. Andsager, "How Newspapers Framed Breast Implants in the 1990s," Journalism & Mass Communication Quarterly 76 (autumn 1999): 551-64. Six issues identified in their study include (1) manufacturers' actions, (2) implant recipients' actions, (3) ruling for the defendants, (4) ruling for the plaintiffs, (5) health risks, and (6) lack of health risks.
17. Kadyan, "USA: Is the Botox Party Over?"
18. Allen Lack, executive producer, Face to Face with Connie Chung, CBS, New York, November 1991 (originally aired in December 1990).
19. Freimuth et al., "Covering Cancer: Newspapers and the Public Interest"; Sooyoung Cho, "Network News Coverage of Breast Cancer, 1974 to 2003," Journalism & Mass Communication Quarterly 83 (spring 2006): 116-30.
20. Powers and Andsager, "How Newspapers Framed Breast Implants in the 1990s"; Freimuth et al., "Covering Cancer: Newspapers and the Public Interest"; Cho, "Network News Coverage of Breast Cancer."
21. Barney G. Glaser and Anselm L. Strauss, "The Constant Comparative Method of Qualitative Analysis," in The Discovery of Grounded Theory: Strategies for Qualitative Research, ed. Barney G. Glaser and Anselm L. Strauss (Chicago: Aldine Publishing Company, 1967), 101-15.
According to the authors, the purpose of the constant comparative method is "to generate theory more systematically, than allowed by the second approach, by using explicit coding and analytic procedure." The analyst usually starts coding each incident in his or her data into as many categories of analysis as possible as categories emerge or as data emerge that fit an existing category. The analyst stops coding when they become theoretically saturated.
22. Susan M. Zimmerman, Silicone Survivors: Women's Experiences with Breast Implants (Philadelphia: Temple University Press, 1998).
23. Susan L. Binson and William L. Benoît, "Dow Coming's Image Repair Strategies in the Breast Implant Crisis," Communication Quarterly 44 (winter 1996): 29-41.
24. Powers and Andsager, "How Newspapers Framed Breast Implants in the 1990s."
25. Zimmerman, Silicone Survivors: Women's Experiences with Breast Implants.
26. Robert M. Entman, "Framing: Toward Clarification of a Fractured Paradigm," Journal of Communication 43 (winter 1993): 51-58.
27. Julia B. Corbett and Motomi Mori, "Medicine, Media, and Celebrities: News Coverage of Breast Cancer, 1960-1995," Journalism & Mass Communication Quarterly 76 (summer 1999): 229-49.
28. Robert A. Logan, "Popularization Versus secularization: Media Coverage of Health," in Risky Business: Communicating Issues of Science, Risk, and Public Policy, ed. Lee Wilkins and Philip Patterson (NY: Greenwood Press, 1991), 44-59.
29. Cho, "Network News Coverage of Breast Cancer."
30. Richard V. Ericson, Patricia M. Baranek, and Janet B. Chan, Negotiating Control: A Study of News Sources (Toronto, Canada: University of Toronto Press, 1989).
31. Fabienne Darling-Wolf, "Framing the Breast Implant Controversy: A Feminist Critique," Journal of Communication Inquiry 21 (spring 1997): 84-89.
32. Goodness of fit chi-square tests were calculated to compare the abstracts and transcripts on the different coding categories. Chi-square score for types of plastic surgery was (X^sup 2^ [df = 5] = 0.29, n.s.); for benefit/risk frame types was (X^sup 2^ [df = 3] = 0.97, n.s.); for types of issue was (X^sup 2^ [df = 6] = 1.00, n.s.); and for source types was (X^sup 2^ [df = 6] = 0.85, n.s.). The tests indicate that abstracts and transcripts were not significantly different for this study purpose.
33. The study used a few surgeries as key words (e.g., breast implants, liposuction, facelift). The use of certain surgeries inherently means that there will be more of those abstracts than on surgical procedures not included. Recent statistics (The American Society for Aesthetic Plastic Surgery 2005 Statistics) indicate that the top five surgical procedures cosmetic procedures in 2005 were liposuction (455,489 procedures), breast implants (364,610 procedures), cosmetic eyelid surgery (231,467 procedures), nose reshaping (200,924 procedures), and tummy rucks (169,314 procedures). In addition, the top five non-surgical procedures in 2005 were Botox injections (3,294,782), laser hair removal (1,566,909), Hyaluronic acids (1,194,222), Microdermabrasion (1.023,931), and chemical peels (556,172). Although all the popular (non) surgical procedures shown in ASAPS statistics were not included as key words, many procedures were included in the study (e.g., liposuction, breast implants, eyelid surgery, nose jobs, Botox, and laser surgery). Source: "Cosmetic Surgery Quick Facts: 2005 ASAPS Statistics," The American Society of Aesthetic Plastic Surgery, http://www.surgery.org/press/procedurefactsasqf.php, retrieved November 15, 2006.
34. Richard Landis and Gary G. Koch, "The Measurement of Observer Agreement for Categorical Data," Biometrica 33 (3, 1977): 159-74.
35. Cho, "Network News Coverage of Breast Cancer."
36. Powers and Andsager, "How Newspapers Framed Breast Implants in the 1990s."
37. Michael McCarthy, "Botox Maker Plans $50 million Ad Campaign," USA Today, April 29, 2002, http://www.usatoday.com/ money / advertising / 2002-04-29-botox-marketing.htm, accessed November 12, 2006; Rhonda Rundle, "Wrinkle Treatment Gets a New LineMedicis seeks to Broaden Market by Creating Contest For 'Hottest Mom in America'," the Wall Street Journal, September 12, 2006, http://users1.wsj.com/lmda/do/checkLogin?mg=wsj-users1&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB115802072450160097.html, accessed November 12, 2006.
38. Zimmerman, Silicone Survivors: Women's Experiences with Breast Implants.
39. e.g., Cho, "Network News Coverage of Breast Cancer."
40. Deborah A. Sullivan, Cosmetic Surgery: The Cutting Edge of Commercial Medicine in America (New Jersey: Rutgers University Press, 2001).
Sooyoung Cho is an assistant professor in the School of Journalism and Mass Communication at the University of South Carolina.…
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Publication information: Article title: TV News Coverage of Plastic Surgery, 1972-2004. Contributors: Cho, Sooyoung - Author. Journal title: Journalism and Mass Communication Quarterly. Volume: 84. Issue: 1 Publication date: Spring 2007. Page number: 75+. © Association for Education in Journalism and Mass Communication Winter 2007. Provided by ProQuest LLC. All Rights Reserved.
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