Background Psychological processes consisting of body image and self-esteem are considered key to the motivation for cosmetic surgery (CS). The current study aimed to investigate such processes as well as social support, perception of other people's opinion, and sex life satisfaction of Taiwanese female CS candidates. Further analyses were conducted to identify which processes predicted motivation for CS. Method Questionnaires comprising subscales of the Multidimensional Body-Self Relations Questionnaire, the Rosenberg Self-Esteem Scale, the Perception of Other Peoples' Opinion Scale, and social support and sex life questions were completed by Taiwanese female CS candidates (n = 85) preoperatively. The results were compared with those for a sex-matched nonsurgical control group (n = 105) as well as previously published data and reference norms. Correlation and multiple regression analysis also was conducted to identify any relationship between variables as well as which variable best predicted the likelihood of a patient having surgery. Results A total of 29 CS candidates (34.1%) reported before their surgical consultation that they would "very likely" or "likely" have CS, and 54 (63.5%) received support from all three social groups, namely, family, friends, and partner. The body image (appearance evaluation, orientation, and body area satisfaction) of the CS candidates was not significantly different from that of the control group. The former had significantly higher selfesteem and perception of other people's opinion scores. Self-esteem was positively correlated with appearance evaluation (r = 0.484; p < 0.01) and body area satisfaction (r = 0.494; p < 0.01). Body area satisfaction had a fair degree of negative correlation with the likelihood of having CS (r = -0.413; p < 0.01). Regression analysis indicated that only body area dissatisfaction predicted the likelihood of having CS, accounting for 29.4% of the total variance. Conclusions The results of this study indicate that the Taiwanese female CS candidates did not have higher body image dissatisfaction or greater body image investment than the control group. However, body area dissatisfaction was the only significant predictor for the likelihood of having CS, a feature not previously recognized in Asian CS candidates. The higher self-esteem of the CS candidates opposes the view that low self-esteem is a principal motivating factor for CS.
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