In recent years, popularity of cosmetic surgery procedures has greatly increased in Western culture and society and women are more frequently opting to have cosmetic surgery in order to change their real or imagined bodily defects. In reviewing the following literature on cosmetic surgery, body image, mass media influences on body image, sociocultural and social-comparison theories, history and development of culture, and body image dissatisfaction, it is evident that there is a complex relationship between these influences and cosmetic surgery seeking behavior. Specifically, mass media and cultural influences contribute greatly to the development of body image and self-concept, in turn becoming either a protective factor against, or a risk factor for compulsive behaviors. This study conceptualizes compulsive cosmetic surgery seeking as a process addiction and utilizes a self-psychological framework as a platform for understanding the effects of these issues in an individual's development and presentation of the self. Hypothetical cases of individuals who have had multiple cosmetic surgery procedures are then examined in an effort to understand and conceptualize presentations of self, culture, body image, and ultimately the decision to surgically change one's appearance.