Trait perfectionism, perfectionistic self-presentation, and thoughts about having cosmetic surgery performed (TAHCSP) were examined. In Study 1, perfectionistic self-promotion (PSP) and nondisplay of imperfection (NDP) correlated with TAHCSP in 292 university women. Both Study 2 (N = 527 university women and 209 university men) and Study 3 (N= 43 gym-going women and 52 gym-going men) replicated findings from Study 1. Studies 2 and 3 extended Study 1 by showing that (a) socially prescribed perfectionism (SPP) correlated with TAHCSP and (b) PSP, NDP, and SPP correlated with TAHCSP in women only. PSP and NDP mediated the relation between SPP and TAHCSP in studies 2 and 3. Results held after controlling for age and body mass index. Perfectionists’ pursuit of appearance ideals, fault-finding predilection, and concern over others’ evaluations may generate and maintain TAHCSP.