Purpose: The increase of cosmetic surgery procedures is partly motivated by more positive attitude toward cosmetic surgery as a means of improving physical appearance. In this study factors expected to predict need for cosmetic surgery were examined. Methods: A descriptive design was used with 321 high school girls who completed a questionnaire about sociocultural attitudes toward appearance, body image, self-esteem, and need for cosmetic surgery. Stepwise multiple regression analysis was performed to examine factors affecting need for cosmetic surgery. Results: Bivariate correlations showed that need for cosmetic surgery was positively correlated with internalization and awareness of sociocultural attitudes toward appearance, and appearance orientation in body image and negatively correlated with self-esteem and ideal body mass index (BMI). Multiple regression showed that the predictive variables explained 22.1% in need for cosmetic surgery. The significant factors influencing need for cosmetic surgery were greater internalization and awareness of sociocultural attitudes toward appearance, better appearance evaluation and higher appearance orientation in body image, lower self-esteem, and lower ideal BMI. Conclusion: Overall, results of this research suggest that prevention of media influence and body image disturbances, and promotion of self-esteem are very important to young women.