Expectations, Body Image Pressure, and Willingness to Undergo Cosmetic Procedures Among First-Time Aesthetic Plastic Surgery Seekers: A Cross-Sectional Study.

Background Interest in aesthetic surgical and non-surgical procedures has increased alongside greater public visibility of cosmetic treatment and widespread exposure to appearance-focused social media content. First-time aesthetic procedure seekers may approach consultation with varying levels of body image pressure, social influence, and expectations regarding appearance, confidence, and social acceptance. Objective This study aimed to assess expectations, body image pressure, and willingness to undergo cosmetic procedures among first-time aesthetic plastic surgery seekers and to identify factors associated with willingness to proceed with treatment. Methods A cross-sectional study was conducted among 200 adults attending a plastic surgery and aesthetic medicine clinic for their first aesthetic consultation. Participants with no previous history of cosmetic surgical or non-surgical treatment were recruited through consecutive sampling. Data were collected using a structured, study-specific questionnaire covering sociodemographic characteristics, preferred aesthetic procedures, treatment expectations, body image pressure, appearance-related social media exposure, and willingness to undergo a cosmetic procedure. Categorical variables were summarized using frequencies and percentages, while age was reported as mean and standard deviation. Associations were assessed using the chi-square test, and binary logistic regression was performed to identify factors independently associated with willingness. Adjusted odds ratios were reported with 95% confidence intervals, and p < 0.05 was considered statistically significant. Results The mean age of participants was 28.6 ± 7.4 years, and 132 (66.0%) were female. High body image pressure was identified in 124 participants (62.0%), while 138 (69.0%) reported willingness to undergo a cosmetic procedure. Willingness differed significantly across body image pressure categories (χ²(2) = 27.29, p < 0.001; Cramér's V = 0.37). In multivariable analysis, high body image pressure showed the strongest association with willingness (adjusted odds ratio (AOR): 3.84; 95% confidence interval (CI): 1.92-7.68; p < 0.001). Frequent appearance-related social media exposure (AOR: 2.41; 95% CI: 1.28-4.54; p = 0.006), expectation of improved self-confidence (AOR: 2.76; 95% CI: 1.39-5.48; p = 0.004), and previous negative comments about appearance (AOR: 1.93; 95% CI: 1.01-3.69; p = 0.046) were also significantly associated with willingness. Sex and age group were not statistically significant after adjustment. Conclusion Among first-time aesthetic procedure seekers, body image pressure, frequent appearance-related social media exposure, expectation of improved self-confidence, and previous negative comments about appearance were associated with greater willingness to undergo cosmetic procedures. These findings support careful pre-procedure counselling and assessment of appearance-related concerns, expectations, and social influences. Because of the cross-sectional design, causal relationships cannot be established. Multicentre and longitudinal studies using validated psychological measures are needed to clarify the temporal and contextual factors influencing cosmetic-procedure decisions.