Partner infidelity is a considerable threat to romantic relationships, and is associated with a greater likelihood of relationship dissolution (Allen and Atkins, 2012). Preventing partner infidelity in long-term relationships has been an adaptive problem throughout human evolutionary history (Buss, 1988). A man whose partner commits sexual infidelity is at risk for cuckoldry—investing resources into genetically unrelated offspring. A woman whose partner commits emotional infidelity is at risk for losing partner-provisioned resources for her and her offspring. Men and women therefore use a variety of strategies to reduce the risk of partner infidelity, and to maintain their long-term romantic relationships (Buss, 1988; Barbaro et al., 2015).

Men and women perform mate retention behaviors to reduce the likelihood of their partner’s infidelity or relationship dissolution (Buss, 1988). Mate retention behaviors can range from socially acceptable behaviors (e.g., appearance enhancement) to socially unacceptable behaviors (e.g., physical violence toward potential rivals). Mate retention behaviors are subsumed by two superordinate domains of Benefit-Provisioning mate retention and Cost-Inflicting mate retention (Miner et al., 2009; Lopes et al., 2016; Atari et al., 2017a). Benefit-Provisioning mate retention includes behaviors that reduce the likelihood of partner infidelity by increasing relationship satisfaction. Cost-Inflicting mate retention includes behaviors that reduce the likelihood of partner infidelity by lowering the partner’s self-esteem (Miner et al., 2009).

Benefit-Provisioning and Cost-Inflicting mate retention behaviors can either be directed toward an individual’s romantic partner (intersexual competition), or toward potential rivals (intrasexual competition) (Buss, 1988). Women, in particular, compete intersexually and intrasexually within the domain of physical attractiveness (Buss and Schmitt, 1993). As part of Benefit-Provisioning mate retention, women (relative to men) report more frequently engaging in Appearance Enhancement behaviors (e.g., making sure they look “extra attractive” for their partner) to increase their partner’s perception of their mate value and therefore their partner’s satisfaction with the relationship. As part of Cost-Inflicting mate retention, on the other hand, women derogate a female rival’s physical attractiveness (e.g., pointing out to their partner the flaws of another woman) to decrease the rival’s mate value, thereby increasing their own relative mate value.

One way a woman can increase her perceived mate value is through the use of cosmetics (Etcoff et al., 2011) and undergoing cosmetic surgery (see Swami et al., 2008). Cosmetic enhancement (e.g., use of cosmetics, body modification) has existed for thousands of years (Kalantar-Hormozi, 2013; Frederick et al., 2016). For example, techniques to reshape or reconstruct nasal deformities were practiced by ancient Greeks, Europeans, and Indians long before advances in modern medical procedures (Frederick et al., 2016). Breast implants—made of paraffin, beeswax, and vegetable oil—were used to enlarge breasts in the 19th and early 20th centuries (Frederick et al., 2016). Cosmetic surgery, therefore, is one method by which an individual can increase their perceived physical attractiveness (Etcoff et al., 2011). Because women’s mate value is more dependent on physical attractiveness than is men’s mate value (e.g., Conroy-Beam et al., 2015), it is not surprising that over 90% of cosmetic surgery patients are women (Frederick et al., 2016). Recent qualitative research suggests that a large number of female patients pursue cosmetic surgery for relationship-related reasons (Locatelli et al., 2017).

Women, more than men, may therefore consider cosmetic surgery as a means to improve their relationship quality, such that cosmetic surgery is a modern means of enhancing physical attractiveness. Women who undergo cosmetic surgery aim to improve their perceived attractiveness. Post-operative assessments indicate that women appear younger, more likeable, and more feminine following cosmetic procedures (Reilly et al., 2015). Men, in contrast, are less interested in cosmetic surgery (Frederick et al., 2007) as a means of improving their physical attractiveness because men’s (relative to women’s) mate value depends upon their social status and resource-acquisition abilities (Buss and Schmitt, 1993).

The current study examines whether women’s, but not men’s, consideration of cosmetic surgery is associated with mate retention behaviors. Interest in cosmetic surgery may be correlated with Benefit-Provisioning mate retention. Women’s cosmetic surgery can augment their physical attractiveness and decrease their perceived age (Reilly et al., 2015). Enhanced physical attractiveness may lead to an increase in relationship satisfaction (see Swami and Mammadova, 2012)—consistent with the conceptualization of Benefit-Provisioning mate retention (Miner et al., 2009). Cosmetic surgery may be associated with Cost-Inflicting mate retention. Because cosmetic surgery artificially enhances a woman’s perceived attractiveness, women who undergo cosmetic procedures may thereby indirectly derogate intrasexual competitors. Women’s enhanced appearance, moreover, may inflate mate value discrepancy within a romantic dyad, consequently resulting in a decrease in their partner’s self-esteem—consistent with the conceptualization of Cost-Inflicting mate retention (Sela et al., 2016). It was therefore expected that consideration of cosmetic surgery will be positively associated with both Benefit-Provisioning mate retention (Hypothesis 1) and Cost-Inflicting (Hypothesis 2) mate retention for women, but not men.

The associations between considering cosmetic surgery and tactic- and domain-level mate retention behaviors in men and women are separately summarized in Table 1. As can be seen in domain-level correlations, women’s interest in cosmetic surgery is significantly associated with Benefit-Provisioning (r = 0.23, p = 0.01) and Cost-Inflicting (r = 0.31, p < 0.01) mate retention behaviors. The correlation coefficients between men’s interest in cosmetic surgery and mate retention domains were non-significant (ps > 0.34). We conducted Fisher’s r-to-z transformation on correlations for women (n = 110) and men (n = 93) to identify sex differences in the magnitude of the correlations coefficients between mate retention behaviors and consideration of cosmetic surgery (see Table 1). Zero-order correlations suggested that consideration of cosmetic surgery was negatively associated with education (r = -0.28, p < 0.01). The correlations between consideration of cosmetic surgery and age (r = 0.05, p = 0.50), relationship length (r = 0.06, p = 0.46), and BMI (r = -0.07, p = 0.34) were non-significant.

We conducted a hierarchical moderated regression analysis to test the study hypotheses. In Step 1, the demographic variables of sex, age, education, relationship length, and BMI were entered. In Step 2, Benefit-Provisioning mate retention and Cost-Inflicting mate retention (both variables mean centered) were entered. In Step 3, both two-way interaction terms were entered—Benefit-Provisioning mate retention interacting with sex, and Cost-Inflicting mate retention interacting with sex—with consideration of cosmetic surgery as the dependent variable (see Table 2). A two-way interaction emerged between Benefit-Provisioning mate retention and sex.

We conducted simple slopes analyses, as recommended by Aiken and West (1991), to deconstruct the two-way interaction. The simple slopes tests were conducted using values one standard deviation above the mean to represent individuals who perform relatively more frequent Benefit-Provisioning mate retention, and one standard deviation below the mean to represent individuals who perform relatively less frequent Benefit-Provisioning mate retention. Supporting Hypothesis 1, the slope of the line representing the association between Benefit-Provisioning mate retention and consideration of cosmetic surgery was significant and positive for women (β = 0.35, t = 2.77, p < 0.01), but not for men (β = 0.09, t = 0.81, p = 0.42). The predicted values for this interaction are displayed in Figure 1. A two-way interaction between Cost-Inflicting mate retention and sex did not emerge and, therefore, Hypothesis 2 was not supported.

The current study examined whether women’s, but not men’s, consideration of cosmetic surgery is associated with Benefit-Provisioning and Cost-Inflicting mate retention. The results revealed a two-way interaction between Benefit-Provisioning mate retention and sex. Hypothesis 1 was supported: for women (but not men), there was a positive association between Benefit-Provisioning mate retention and consideration of cosmetic surgery, such that women who more frequently perform Benefit-Provisioning mate retention also reported greater consideration of cosmetic surgery. Hypothesis 2 was not supported: there was no interaction between Cost-Inflicting mate retention and sex to predict consideration of cosmetic surgery.

In tactic-level analyses, results suggested that women’s consideration of cosmetic surgery is associated with six mate retention tactics (i.e., vigilance, monopolization of time, punish mate’s infidelity threat, derogation of competitors, physical possession signals, and possessive ornamentation). However, men’s consideration of cosmetic surgery was associated with two mate retention tactics (i.e., monopolization of time and verbal possession signals). These findings indicate that women more generally consider cosmetic surgery as a means of retaining their long-term mates by improving their physical attractiveness.

The sex difference of the association between Benefit-Provisioning mate retention and consideration of cosmetic surgery may reflect differences in domains of intersexual competition between men and women. Men, more than women, prioritize physical attractiveness in mates (Buss and Schmitt, 1993). Women who improve their physical attractiveness via cosmetic surgery, therefore, may be able to attract and retain men of higher mate value. For example, women can reconstruct their waist-to-hip ratio—an important indicator of fecundity—to aesthetically ideal proportions by a buttock implant surgery or abdominoplasty. Breast symmetry and size can be augmented or reduced to meet an aesthetic ideal. Men’s attractiveness indicators (e.g., muscularity), however, are less easily modified through cosmetic surgery procedures (Frederick et al., 2016). Men’s social status and resource-acquisition, in contrast to physical attractiveness, moreover, are prioritized more in women’s mate selection (Conroy-Beam et al., 2015). The results of the current study are in accord with the findings of Atari et al. (2017b) who documented that single women who report greater interest in cosmetic surgery set higher standards for potential mates.

Research from an evolutionary psychological perspective has investigated the ways in which aspects of women’s physical attractiveness provide cues to health, youth, and fertility (e.g., Lewis et al., 2015). Men have evolved preferences to desire physically attractive women (Conroy-Beam et al., 2015), and women have historically used a variety of techniques to enhance their attractiveness (Buss, 1988). Cosmetic surgery—as a means to increase perceived attractiveness—may therefore be understood as a modern form of appearance enhancement. The primary aim of cosmetic surgery from an evolutionary psychological perspective may be a modern means of Appearance Enhancement—which women (relative to men) are more likely to deploy as part of a broader strategy of Benefit-Provisioning mate retention (Buss, 1988).

The current study also adds to the growing literature on the psychology of cosmetic surgery (e.g., Kalantar-Hormozi et al., 2016; also see Sarwer et al., 1998). Chegeni and Atari (2017), for example, documented that Machiavellianism is associated with considering cosmetic surgery in women, but not men. Paired with the current findings and previous reports on sex differences in cosmetic surgery settings (Naraghi and Atari, 2016), it may be concluded that the motivations underlying cosmetic surgery differ between the sexes. Men and women may obtain different benefits through cosmetic surgery. Women, for example, may be more successful in attracting and retaining higher quality mates as a result of cosmetic procedures. Our correlational findings further suggests that interest in cosmetic surgery is associated with a set of mate retention tactics in women.

Women, relative to men, are more likely to use appearance enhancement tactics as part of a broader strategy of Benefit-Provisioning mate retention to minimize the likelihood of partner infidelity (Buss, 1988). The current study examined whether consideration of cosmetic surgery was associated with performance frequencies of mate retention behaviors. The results reveal a positive association between consideration of cosmetic surgery and performance frequencies of Benefit-Provisioning mate retention for women, but not men. Thus, women may undergo cosmetic surgery to increase their perceived attractiveness as a means to retain their romantic partner.

Participants were eligible to participate in this survey if they were at least 18 years of age and in a committed, heterosexual relationship. Interested and eligible participants gave consent. This study was carried out in accordance with the recommendations of the ethics committee of the Department of Psychology of University of Tehran. All subjects gave written informed consent in accordance with the Declaration of Helsinki.

All authors developed the study concept and contributed to the study design. MA and RC collected the data. MA, NB, YS, and TS performed the data analyses. MA, NB, and RC drafted the manuscript. YS and TS provided critical revisions to the manuscript. All authors reviewed and approved the final version of the manuscript for submission.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.