The Mediating Effect of Self-Esteem and Relationship Satisfaction on the Relationship Between Body Image and Surgical Demand in Young Adults Planning Aesthetic Surgery

Background Cosmetic surgery is shaped not only by physical concerns but also by psychosocial factors such as body perception, self-esteem and relationship satisfaction; however, despite the increasing demand, the interaction of these factors is not sufficiently explained in the literature. This study aims to examine the mediating effect of self-esteem and relationship satisfaction on the relationship between body perception and surgical demand in young adults scheduled for plastic surgery. Methods This cross-sectional and multivariate correlational study was conducted in the Plastic and Reconstructive Surgery Clinic of a public hospital between March 2024 and March 2025. The study was conducted with 547 volunteer individuals. The research was structured within the framework of the Psychosocial Well-Being Model. Data were collected by face-to-face interview technique using the Patient Identifying Information Form and Aesthetic Surgery Acceptance, Body Perception, Rosenberg Self-Esteem and Relationship Satisfaction Scales. Statistical analyses were performed with SPSS and JAMOVI programs. Results Aesthetic surgery acceptance, body perception, self-esteem and relationship satisfaction levels were found to be 89.79 ± 3.41, 82.32 ± 6.15, 26.42 ± 2.09 and 14.62 ± 2.43 points, respectively. According to the results of the parallel equation model, body perception affects surgical acceptance both directly (β = 0.0932, p < 0.001) and indirectly through self-esteem (β=-0.0261, p = 0.021) and relationship satisfaction (β = 0.0169, p = 0.016). Body perception positively affects self-esteem (β = 0.1342, p < 0.001) and relationship satisfaction (β = 0.0952, p < 0.001), while an increase in self-esteem decreases acceptance of surgery (β=-0.1942, p = 0.018) and increases relationship satisfaction (β = 0.1771, p = 0.008). The total effect was significant in the model (β = 0.0840, p < 0.001). Conclusions The level of acceptance of plastic surgery is significantly related to psychosocial factors such as body perception, self-esteem and relationship satisfaction. While body perception directly and indirectly affects surgical demand, high self-esteem decreases surgical interest, and relationship satisfaction increases it. These findings suggest that aesthetic decisions are determined by psychological and social factors as well as physical. Trial registration: Not applicable.