Tampa topped the list and Miami, St. Petersburg and Orlando were among the top 20 cities most concerned about appearance in a report in Men's Health magazine that studied what people are willing to do to look their best.

Other southern cities also ranked high including Plano, Texas, which captured the No. 2 spot, followed by Atlanta at No. 3 and Dallas, which came in fifth.

Matt Marion, the executive editor of the magazine, said the weather is a huge factor in explaining why southern cities are so vain.

"In Florida you have some of the highest average temperatures year round and people aren't hiding under sweaters and bulky clothes. Their bodies are on display a lot more often than elsewhere in the country," he said in an interview.

"You are on display, warts and all, and if you can get rid of some of those warts through surgery, all the better."

The magazine looked at a variety of factors to compile the ranking, including the number of cosmetic dentists, plastic surgeons and tanning salons per 100,000 people.

"It turns out that there are a lot of ways to measure vanity," said Marion, adding that ranking reflected how cities rank in relation to each other.

It also compared the use of Botox and sales of hair dyes, teeth whiteners and shapewear clothing, rates of cosmetic surgery, and surveys in which people said what they would do to look better and younger.

"In Florida you have a demographic that could embrace procedures to help them look younger, everything from surgical to non-surgical, even dying gray hair," Marion explained.

The state's high unemployment rate may also play a part, he added, with people eager to look their best in a competitive job market.

While southern cities dominated the top, Midwestern urban areas were in abundance at the bottom of the list with Des Moines, IA, Lincoln, NE and Sioux Falls, SD, ranked as the least vain U.S. cities.

"You can interpret a lot of things from it. One is that it is reflective of a Midwest sensibility of being more practical and down-to-earth," said Marion.

Despite being the center of the entertainment industry, Los Angeles was No. 60 on the list, way behind New York and Washington, which ranked 17th and 18th.

Marion stressed that the ranking did not reflect any value judgments about the cities at the top or the bottom of the list.

"It is good, obviously to a certain degree, to care about your appearance and to try to look good. By the same token you can also take it to an extreme. Obsessing too much can be bad."

(Reporting by Patricia Reaney; Editing by M.D. Golan)

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