Our study investigated factors that influence attitudes toward cosmetic surgery in middle-aged women. A sample of 108 women, aged between 35 and 55 years, completed questionnaire measures of body dissatisfaction, appearance investment, aging anxiety, media exposure (television and magazine), and attitudes toward cosmetic surgery (delineated in terms of general attitudes, social motivations, and actual consideration). Body dissatisfaction, appearance investment, aging anxiety, and both media variables predicted some facet of attitudes toward cosmetic surgery. Specifically, appearance investment, aging anxiety, and television exposure were unique predictors of endorsement of social motivations for cosmetic surgery, whereas body dissatisfaction, appearance investment, and television exposure were unique predictors of actual consideration of cosmetic surgery. Regression analysis revealed that the effects of media on cosmetic surgery attitudes were primarily direct. We concluded that there are multiple influences on attitudes toward cosmetic surgery for women of middle age.