Objective: This study aimed to examine factors influencing attitudes toward cosmetic surgery among university students. Sociocultural attitudes toward appearance, physical appearance perfectionism, and appearance investment were considered as predictors of tendency toward cosmetic surgery.

Methods: This study was a descriptive-correlative research. One stage cluster sampling was utilized to collect data of 631 students (male and female), aged between 18 and 49 years (21.83 ± 4.09 y) of Islamic Azad university (from North, South, East, West, Medical Sciences and Dentistry branches) with different degrees and majors during the first semester of 2013-14 academic year. A 77-item questionnaire was utilized to measure sociocultural attitudes toward appearance, appearance perfectionism, appearance investment, attitudes toward cosmetic surgery, and demographic data. First a pilot study was conducted on 30 students with similar ability and background to the survey target population to obtain an assessment of the validity and reliability of the translated questionnaires in Persian. A stepwise regression analysis was utilized to address the prediction power of tendency toward cosmetic surgery.

Results: Media influences as sociocultural attitudes toward appearance, appearance investment, appearance perfectionism through two ways worry about imperfection and hope for perfection, which were significantly correlated to attitude toward cosmetic surgery. Variables were not identical for men and women apart from worry about imperfection subscale. Furthermore, media influences, appearance investment, and worry about imperfection accounted for 27% of variance of positive attitude toward cosmetic surgery. Hope for perfection as the second subscale of appearance perfectionism has no effect on predicting tendency toward cosmetic surgery.

Conclusion: These findings suggest that a greater perfectionist tendency and psychological investment in physical appearance (among sociocultural attitudes toward appearance) predict more favorable attitudes toward cosmetic surgery.