Demographic Survey of Aesthetic Interests and Concerns (MOSAIC): US Survey Study of Facial and Body Aesthetic Concerns and Treatment Interests of Hispanic and Latina Women

J Clin Aesthet Dermatol. 2026;19(8 Suppl 2):38–46.

Sabrina Fabi, MD; Jacob Beer, MD; Gaurav Bharti, MD, FACS; Charles Boyd, MD; Vivian Bucay, MD; Rosalyn George, MD; Elizabeth Houshmand, MD, FAAD; Birgitte Sondergaard, PhD; Agnesa Avanesian, PhD; and Nazanin Ashourian, PhD

Dr. Fabi is with Cosmetic Laser Dermatology, San Diego, California. Dr. Beer is with Beer Dermatology, West Palm Beach, Florida. Dr. Bharti is with HKB Cosmetic Surgery, Charlotte, North Carolina. Dr. Boyd is with BOYD, Birmingham, Michigan. Dr. Bucay is with Bucay Center for Dermatology and Aesthetics, San Antonio, Texas. Dr. George is with Wilmington Dermatology Center, Howe Creek Landing, North Carolina. Dr. Houshmand is with Houshmand Dermatology and Wellness, Dallas, Texas. Drs. Sondergaard, Avanesian, and Ashourian are with Allergan Aesthetics, an AbbVie company, Irvine, California.

FUNDING: Funding for this supplement was provided by Allgeran Aesthetics, an AbbVie company, and Research Execute Learn.

Abstract: OBJECTIVE: To evaluate aesthetic concerns and treatment interests of diverse participants in a large United States (US)-based study. Herein, we report the findings for Hispanic/Latina female participants. METHODS: Aesthetically inclined participants (aged 22–85 years) completed an online survey (February 2022–April 2022) to rate the frequency and degree of bothersomeness of 41 facial and 31 body characteristics and the likelihood of seeking professional treatment within the next year. The relative bothersomeness of each characteristic was ranked using a Maximum Difference scaling framework. Participants also ranked 48 aesthetic treatments by degree of interest. RESULTS: Of 3,974 participants, 748 (18.8%) self-identified as Hispanic/Latina and female. Top facial concerns included submental fat, under-eye dark circles/bags, and hair loss/thinning; likely treatments included frown lines/lines between the eyebrows, forehead lines, and dry/dull skin, which did not align with top facial concerns. Top body concerns included stubborn fat in the stomach, flanks, and bra or back area; likely treatments included stubborn fat in the stomach, flanks, and bra or back area, and dry skin and unwanted body hair (equivalent rankings), aligning with top body concerns. Treatments of most interest included nonsurgical fat reduction, facials at a spa or doctor’s office, and nonsurgical skin tightening. LIMITATIONS: Survey data may be subject to self-reporting bias. US data for Hispanic/Latina female participants may not be generalizable to broader populations. CONCLUSION: Findings from this subgroup analysis of a large study may help practitioners better tailor treatment plans based on facial and body aesthetic concerns and treatment interests of Hispanic/Latina women. KEYWORDS: Aesthetic treatment, face, body, Hispanics, Latinas, female, Maximum Difference Scaling, survey methods

Introduction

Aesthetic procedures for both the face and body have become increasingly popular, with up to 70% of individuals in the United States (US) considering some form of treatment.¹ With this increasing interest, understanding the aesthetic needs of different sex/gender, racial, ethnic, and age groups can assist practitioners in providing individualized care.² However, studies of aesthetic inclinations have often focused on White populations,^3–7 whereas the aesthetic needs of Hispanic/Latino individuals, the second largest ethnic group in the US,⁸ have not been extensively studied.

“Hispanic” generally refers to anyone from a Spanish-speaking country and Latino/a includes individuals from anywhere in Latin America.⁹ As such, the racial and ethnic backgrounds of Hispanic/Latina women are varied. This diverse background leads to both more similarities and differences in skin types and facial features of this group compared to other racial groups or ethnicities.¹⁰ Hispanic/Latina skin is more sebaceous than White skin, and melasma/hyperpigmentation is more common.^10–13 As with women of other racial and ethnic backgrounds, aging in Hispanic/Latina women can lead to a thicker, heavier midcheek area, nasolabial folds, and fat accumulation.^10,12,14 A series of surveys previously presented the facial concerns, aesthetic treatment interests, and barriers to seeking treatment in a variety of women in the US, including Hispanic/Latina American women,¹⁵ Asian American women,⁷ African American women,⁶ and White women.³ Hispanic/Latina women reported that their aesthetic goal was to look good for their age, and their treatment interests reflected this, with most of the participants stating that they would consider injectables.¹⁵ The most bothersome facial characteristics were sagging under the chin/double chin, dark circles under the eyes, and upper facial lines, such as crow’s feet lines and forehead lines.¹⁵

To gain further insights into the aesthetic concerns of different demographic groups in the US, a survey was administered to aesthetically inclined adults to examine their concerns across characteristics of the face and body and the potential impact of sex/gender, race, ethnicity, and age. The study used Maximum Difference (MaxDiff) methodology¹⁶ to rank the relative degree of bothersomeness of facial and body characteristics separately and relative interest in specific aesthetic treatments. Participants also reported the characteristics they were most likely to treat over the next year. Data from the overall female population and additional participant subgroups are published separately.^17–21 Herein, we present findings from the subgroup of Hispanic/Latina female participants.

Methods

Study design. Detailed methodology for this study was described in the overview publication.¹⁷ Briefly, this study was an anonymous online survey conducted by Research Learn Execute between February 25, 2022, and April 5, 2022. All participants were blinded to the sponsor throughout the study. Survey questions aimed to understand 4 areas related to aesthetic concerns and treatment interests: participant treatment preferences for the face vs the body, characteristics of the face and body considered most frequently bothersome and relatively most bothersome (top aesthetic concerns), facial and body characteristics most likely to be treated, and the aesthetic treatments that participants were most interested in receiving for the face and body.

Assessment of concern with the face or body. Participants responded to the question, “When you think about your appearance overall, are you more concerned about the appearance of your body or the appearance of your face?” on a 5-point scale. Percentages are presented for participants reporting greater concern with characteristics of the face vs the body, equal concern with the face and the body, and greater concern with the body vs the face.

Identifying and ranking aesthetic concerns. Of 41 facial and 31 body characteristics selected based on prior research and consultation with subject matter experts,¹⁷ participants were asked to select those they had and found bothersome. Participants then ranked these characteristics by bothersomeness using a MaxDiff scaling framework, which involved selecting the most and least bothersome characteristics among each randomized set of 5; facial and body characteristics were presented separately. The MaxDiff score (expressed as a percentage from 0% to 100%) indicated how often a characteristic was chosen as the most bothersome. Top aesthetic concerns were defined as characteristics that were both frequently reported as bothersome and had high MaxDiff scores. The MaxDiff framework has been used in similar studies and was selected for its ability to provide greater differentiation on preference dynamics.^3,7,15,17 Frequently bothersome, most bothersome, and top facial and body aesthetic concerns are also presented across age categories.

Aesthetic treatment intentions. Participants were asked to choose from the same 41 facial and 31 body characteristics and to select those that they were likely to have professionally treated within the next year. Those responding “probably will” or “definitely will” seek treatment were included in the analysis.

Interest in aesthetic treatments.Participants ranked 48 facial or body treatments (grouped by category) based on their likelihood of receiving each within the next year using a MaxDiff scaling framework (Supplemental Table 1). Data for the top 10 treatments among Hispanic/Latina female participants are presented and compared to the corresponding percentages of participants in the overall female population who were interested in those treatments. For all female participants, the percentages of contributions of each race or ethnicity were weighted based on 2022 US Census data.^17,22 The top 10 most desired treatments are also presented across age categories.

Participants. All participants self-reported the racial or ethnic background description that best captures their specific race/origin (see full list in the overview publication).¹⁷ Participants were asked to select the sex/gender they identify with the most (including female, male, transgender female, transgender male, and nonbinary). Body mass index was calculated based on participant self-reported height and weight. Fitzpatrick skin phototype was determined based on a composite score from participant responses to key criteria, including eye and hair color, presence of freckles, sun exposure, and tanning. Eligible participants were adults living in the US aged 22 to 85 years who were aesthetically inclined (ie, those who wanted to enhance their facial and/or body appearance and who expressed willingness to pursue professional treatments) and who had an annual income of at least $35,000 (and reported having some discretionary income). Age categories were defined as Generation Z/young millennial, aged ≤30 years; older millennial, aged 31 to 41 years; Generation X, aged 42 to 57 years; and 58+, aged 58 to 85 years.

This study followed the EPHMRA Code of Conduct and the International Code of Marketing and Social Research Practice. Study participants were informed about data collection and privacy measures such as anonymization of survey responses, as well as the option to withdraw from the study at any time. Participants were required to provide informed consent by agreeing to these terms prior to completing the study.

Results 

Participant demographics. Of the 3,974 participants who met the inclusion criteria and completed the survey, 748 (18.8%) self-identified as Hispanic/Latina and female. Participant demographics and baseline characteristics for this subgroup are presented in Table 1. At study entry, 73% of Hispanic/Latina female participants were in the older millennial or Generation X groups, born in the US (86%), and geographically distributed across the US. Forty-two percent had a normal weight (body mass index of 18.5 to <25 kg/m²), and 79% had Fitzpatrick skin phototype III or IV.

Top aesthetic concerns among Hispanic/Latina female participants. Hispanic/Latina females reported similar rates of aesthetic concern with the body (31%) and the face (32%); 37% reported being equally concerned with both.

Top facial aesthetic concerns among Hispanic/Latina female participants. Of the 41 facial characteristics rated, the 5 most frequently bothersome were dry or dull skin/lack of glow, submental fat, dark circles under the eyes, frown lines/lines between the eyebrows, and uneven skin color/hyperpigmentation (Figure 1).

Based on MaxDiff scaling used to rank the degree of bothersomeness of the 41 facial characteristics, the 5 most bothersome were sagging skin (57%), jowls (53%), under-eye bags or sagginess (49%), and hair loss/thinning hair (48%) and submental fat (48%; equivalent ranks; Figure 1). The top 5 facial aesthetic concerns (ie, characteristics most frequently reported and ranked as most bothersome) were submental fat, dark circles under the eyes, hair loss/thinning hair, frown lines/lines between the eyebrows, and under-eye bags or sagginess (Figure 1).

Among the top 5 facial aesthetic concerns reported in different age groups, dry or dull skin and submental fat were the top concerns for Generation Z/young millennials; dark circles under the eyes, acne scarring, and frown lines/lines between the eyebrows were the top concerns for older millennials; dry or dull skin was the top concern for Generation X; and jowls was the top concerns for women in the 58+ group (Table 2). Generation-specific concerns included acne scarring for Generation Z/young millennials and older millennials, under-eye bags or sagginess in Generation Z/young millennials and 58+, and jowls for 58+ participants (Table 2). The top 5 most frequently bothersome and most bothersome facial characteristics across generations are presented in Supplemental Table 2 and Supplemental Table 3, respectively.

Top body aesthetic concerns among Hispanic/Latina female participants. Of the 31 body characteristics rated, the 5 most frequently bothersome were stubborn fat in the stomach, flanks (sides), bra or back area, and arms, and “buttock not as toned or lifted as I would like” (Figure 2).

Based on MaxDiff scaling, the 5 most bothersome body characteristics revolved around stubborn fat across multiple areas, including stubborn fat around the stomach (61%), flanks (51%), bra or back area (45%), thighs (42%), and arms (40%) and cellulite on the thighs/legs (40%; equivalent ranking; Figure 2). The top 5 body aesthetic concerns (ie, characteristics most frequently reported and ranked as most bothersome) were stubborn fat in the stomach, flanks, bra or back area, arms, and thighs (Figure 2).

Among the top 5 body aesthetic concerns, stubborn fat in the stomach was the top concern across all generations, and all generations also found stubborn fat on the flanks, bra or back area, and arms to be bothersome (Table 2). Generation-specific concerns included cellulite on the thighs/legs in the Generation Z/young millennial and Generation X groups, stubborn fat on the thighs for the older millennial group, and sagging skin for 58+. The top 5 most frequently bothersome and most bothersome body characteristics across generations are presented in Supplemental Table 2 and Supplemental Table 3, respectively.

Treatment likelihood of facial and body characteristics among Hispanic/Latina female participants. The 5 most likely facial characteristics participants would seek professional treatment for within the next year were frown lines/lines between the eyebrows (glabellar lines); forehead lines and dry or dull skin/lack of glow (equivalent ranking); and crow’s feet lines, unwanted hair on the face, and uneven skin color/hyperpigmentation (equivalent ranking; Figure 3; plotted against top facial concerns). Of these, only frown lines/lines between the eyebrows aligned with the top facial aesthetic concerns (Figure 3).

The 5 most likely body characteristics participants would seek treatment for within the next year included stubborn fat around the stomach, flanks, and the bra or back and dry skin/lack of hydration and unwanted body hair (equivalent rankings; Figure 4; plotted against top body concerns). Of these, stubborn fat in the stomach, flanks, and bra or back area were also top body aesthetic concerns (Figure 4).

Degree of interest in aesthetic treatments. The top 10 aesthetic treatments of interest for Hispanic/Latina female participants are presented in Figure 5, along with the percentages for the overall female population who reported interest in those 10 treatments. Of the 48 aesthetic treatments presented (Supplemental Table 1), Hispanic/Latina female participants expressed the most interest in nonsurgical fat reduction. Other top treatment interests included facials at a spa or doctor’s office, nonsurgical skin tightening, tummy tuck/abdominoplasty, neurotoxins (referred to as “wrinkle-relaxing facial injections” in the survey), dermal fillers, liposuction on the body, professional-grade skincare, microdermabrasion, and hydradermabrasion (Figure 5).

The top 10 treatments of interest among Hispanic/Latina female participants were generally similar across age groups (Table 3). Nonsurgical fat reduction and facials at a spa or doctor’s office were the top 2 treatments across all age groups, and most of the other top treatments were the same with some ranking variation.

Discussion

The present study offers insights into the aesthetic concerns and treatment interests of Hispanic/Latina women in the US, with a large sample size and the use of a MaxDiff methodology to capture relative priorities of facial and body concerns. Understanding these concerns and interests and how they differ from women overall and those of other racial and ethnic groups^17–21 may serve as a resource for clinicians on personalizing consultations and treatments for Hispanic/Latina patients as well as creating relevant patient educational materials. The current study builds upon the findings from a previous study of Hispanic/Latina American women by expanding on the selection of facial characteristics, the addition of body aesthetic characteristics, and comprehensive aesthetic treatment categories.¹⁵

Hispanic/Latina female participants reported being equally concerned with facial and body appearance. Several of the top aesthetic concerns for Hispanic/Latina female participants were similar to those of the overall female population, including frown lines/lines between the eyebrows, under-eye bags or sagginess, and hair loss; however, Hispanic/Latina female participants also reported dark circles under the eyes and submental fat as top concerns, whereas the overall population included sagging skin and uneven skin tone. The increased concern with dark circles under the eyes could be due to facial structural changes, as Hispanic/Latina women may develop infraorbital hollowness and shadowing with aging.^10,23,24 Top aesthetic concerns related to the body were the same for Hispanic/Latina female participants and the overall female population, and included stubborn fat around the stomach, flanks, back or bra area, thighs, and arms. The increased concern with submental fat could reflect anatomical/skeletal and aging differences in the lower face between different racial and ethnic groups, as well as cultural paradigms that can affect areas of aesthetic concern.

The facial and body characteristics that Hispanic/Latina female participants were most likely to seek professional treatment for within the next year did not always align with their top aesthetic concern. Of the top facial concerns reported and found bothersome, only frown lines/lines between the eyebrows were considered likely to be professionally treated. Instead, Hispanic/Latina female participants were likely to seek professional treatment for forehead lines, dry/dull skin, crow’s feet lines, unwanted facial hair, and uneven skin tone. This discrepancy may be due to awareness about, access to, and/or perceived cost of available treatment options. Similarly, in the overall female population, only 2 of the top 5 facial concerns were prioritized for seeking professional treatment (frown lines/lines between the eyebrows and uneven skin color).¹⁷ Body characteristics that participants in this population were likely to seek treatment for overlapped with top body concerns reported and found bothersome, including stubborn fat in the stomach, flanks, and bra or back area; however, dry skin and unwanted body hair were also reported as likely to be prioritized for seeking professional treatment, and these did not appear as top body concerns. The body aesthetic concerns for Hispanic/Latina female participants closely align with those of the overall population, with the exception of uneven skin color/hyperpigmentation.¹⁷

Although stubborn body fat was likely to be prioritized for seeking professional treatment, Hispanic/Latina female participants were not as likely to seek professional treatment for their top aesthetic concern, submental fat. Whereas participants reported “buttock not as toned or lifted as I would like” as frequently bothersome, they ranked cellulite on the thighs/legs as more bothersome, but neither were identified as a choice for seeking professional treatment. These differences may indicate areas of discussion, outreach, and education for healthcare providers.

Treatments of interest were similar across generations and generally aligned with the top aesthetic facial concern of forehead lines and top body concerns of stubborn fat in the stomach, flanks, and bra or back area. Nonsurgical fat reduction was rated the top procedure in every age group; tummy tuck/abdominoplasty was included in the top 5 for every group except for Generation X, which ranked it among the top 10. Liposuction was included in the top 5 only for Generation Z/young millennial, though it appeared in the top 10 for every age group. Facials at a spa or doctor’s office were rated at least second in every age group, and neurotoxins were in the top 5 for 58+, Generation X, and older millennial and top 10 for Generation Z/young millennial. Overall, these results are consistent with statistics from the International Society of Aesthetic Plastic Surgery, which reported neurotoxins and nonsurgical fat reduction among the 5 most popular nonsurgical procedures for women and liposuction and abdominoplasty among the 5 most common surgical procedures across age groups.^25,26

The responses from Hispanic/Latina female participants on desired aesthetic treatments were similar overall to those of the total female population. Despite the high reported interest in professionally administered facials, interest in professional-grade skincare, microdermabrasion, and hydradermabrasion was less in the Hispanic/Latina population compared to the total female population,¹⁷ perhaps indicating a lack of knowledge surrounding what are characterized as professional-grade skincare procedures or potential cost barriers.²⁷

The results of the current study align with those of a previous study using the MaxDiff framework for data analysis, an indication that aesthetic concerns for this population have remained consistent over time.¹⁵ In the previous study, the most bothersome areas reported by 401 Hispanic/Latina American participants were sagging under the chin (ie, submental fat; 41%), the under-eye area (37%), and upper facial lines (36% to 37%).¹⁵ The focus on sagging skin by participants in both studies is associated with what is known about facial changes that come with aging in Hispanic/Latina women. Specifically, for many, the face becomes thicker and heavier due to fat pad accumulation in the cheek area, with excess mandibular and submandibular skin and soft tissue, leading to submental fat and jowl formation.^10,12,28 Dark circles under the eyes have also been commonly noted, which may be attributed to, among other causes, the increased prevalence of melanin in Hispanic/Latina skin.^10,28,29

In the prior study¹⁵ and the current study, participants noted that they were aware of and interested in many aesthetic treatments and procedures, including submental fat reduction.When asked about barriers to injectable treatments, which could include those used to reduce submental fat, half reported cost as a barrier as well as safety concerns (37%).¹⁵ Further research is warranted to elucidate the reasoning behind disparities in areas of concern and willingness to treat, which may include fear of procedures involving needles, cost, downtime, number of sessions, or availability of aesthetic treatments.^15,30

This analysis of the Hispanic/Latina female participants in the study has several notable strengths, including a large sample size comprising only Hispanic/Latina female participants and the use of MaxDiff methodology to capture relative priorities more accurately than traditional rating scales with reduced response bias. Similar analyses have focused on the face, with limited data on aesthetic concerns and treatment interests related to the body; this study captured comprehensive coverage of facial and body concerns to create a holistic view of an individual’s aesthetic priorities. Several limitations must be acknowledged. Although subgroup analyses were conducted, further stratification by country of origin, generation, and acculturation status may yield additional nuance. MaxDiff methodology, though robust in revealing relative priorities, does not measure willingness to undergo treatment or financial/access barriers, which remain important determinants of real-world uptake. The study was conducted in the US, and findings may not be generalizable to other regions. Although the survey was opened to members of the transgender and nonbinary communities, responses from members of these groups were limited. Future iterations of the survey should ensure adequate representation and feedback from these groups as aesthetic interests and the aesthetic patient continue to evolve.

Conclusion

By providing insights into the facial and body aesthetic concerns and treatment interests of Hispanic/Latina women in the largest study to date, this research helps to bridge gaps in the knowledge surrounding perspectives on aesthetic treatment for this group. These data will assist aesthetic professionals in identifying key areas of concern and barriers to treatments while helping them offer personalized and more inclusive care for patients who identify as Hispanic/Latina.

Supplemental Materials

Supplemental Tables 1–3

Disclosures 

Drs. Fabi and Boyd have served as advisory board members, speakers, consultants, and investigators for Allergan Aesthetics. Dr. Beer reports working on clinical trials for Allergan Aesthetics, Alpha Tau Medical, Caliway Biopharmaceuticals, Eirion, Incyte, Lilly, Merz, and Veradermics and is a consultant for Allergan Aesthetics, Galderma, and Johnson & Johnson. Drs. Bharti and Houshmand are consultants and advisory board members for Allergan Aesthetics. Dr. George has served as as an investigator, consultant, and speaker for Allergan Aesthetics. Drs. Sondergaard, Avanesian, Ashourian are full-time employees of AbbVie and may own AbbVie stock. Dr. Bucay has no relevant conflicts of interest.

Acknowledgments

Writing and editorial assistance was provided to the authors by Kimberly MacKenzie, PhD and Jessica Brunquell, PhD of Peloton Advantage, an OPEN Health company, and was funded by AbbVie Inc. The authors would like to acknowledge the supplement co-sponsor Research Execute Learn LLC (Randy Long and Drew Minko) for their assistance with the survey design, distribution, collection of data, and analysis of the results.

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