It’s no secret that bullying can lead to some seriously negative psychological effects (i.e. depression or anxiety), but until now, there hasn’t been much talk about it’s link to plastic surgery too. However, a recent study just proved that bullying has a much bigger impact on the desire to get plastic surgery than we would’ve assumed—on both the bullies and their victims.

The research, which was conducted at the University of Warwick, found that both teenage bullies and their victims have an increased desire for plastic surgery than peers their same age. For the study, researchers gathered nearly 2,800 people between the ages of 11 to 16 and screened them for their experiences with bullying. From there, 800 of the preteens—including bullies, the victims, those who were categorized as both and those who weren’t affect by bullying at all—were then evaluated for emotional problems, their levels of self-esteem and their desire to have plastic surgery.

Results found that more than 11.5 percent of bullying victims and 8.8 percent of those who were categorized as both a bully and a victim of bullying, had an “extreme desire” to have plastic surgery. But that’s not all, 3.4 percent of bullying perpetrators were also found to have this extreme desire for cosmetic surgery, whereas less than 1 percent of those who were unaffected by bullying felt that same desire.

When it comes to the reasoning behind the desire for bullies and their victims to get plastic surgery, the study finds that it varies. The perpetrators of bullying want to have plastic surgery to improve their appearance, consequently increasing their social status, while the victims of bullying desire plastic surgery due to their low self-esteem and emotional problems.