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We aimed to examine whether beauty-focused social media engagement mediated the associations of social appearance anxiety, body appreciation, female gender role stress, and social media use duration with cosmetic surgery attitudes. We included 407 female students in this methodological and analytical cross-sectional study at one university in Türkiye. We found through multiple regression that social appearance anxiety (β = 0.112, p = .024), beauty-focused social media engagement (β = 0.404, p < .001), and social media use duration (β = 0.088, p = .048) were positively associated with cosmetic surgery attitudes, whereas body appreciation was negatively associated (β= −0.145, p = .002). We identified significant indirect associations through beauty-focused social media engagement for social appearance anxiety (β = 0.142), body appreciation (β = 0.089), and social media use duration (β = 0.053). We observed an inconsistent mediation pattern for body appreciation. Health care professionals should consider appearance concerns and beauty-focused social media engagement when counseling female university students about cosmetic surgery.
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Calpbinici et al. (2026) studied this question.
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