Current psychosocial and health behavioural covariates of past cosmetic surgery were assessed in a population-based sample (n = 14,100) aged 45-50 years, from the baseline survey of the Women's Health Australia study. Seven percent (n = 982) reported having ever had cosmetic surgery. Multivariate analysis found that self-reported dieting frequency in the past year and body mass index were highly significant covariates of cosmetic surgery; perception about body weight was moderately significant, and satisfaction with body weight was unrelated. A higher likelihood of cosmetic surgery was also found for women who had ever been in a violent relationship, who had been verbally abused recently, smokers, those taking medication for sleep or nerves and those with private hospital insurance. There were moderate associations between cosmetic surgery and state of residence, higher occupational status, alcohol use, higher stress and poorer mental health. Life satisfaction, social support, recent life events, physical health, area of residence, country of birth and marital status, though all significant at the univariate level, were unrelated in multivariate analyses. The psychological and health implications of the findings are discussed.