Cosmetic surgery in the United States has experienced unprecedented growth, representing a $9.4 billion industry in 2005. Although increased marketing and promotional activity have contributed to this growth and physician advertising remains controversial, little is known about the content of cosmetic surgery advertising messages or its affect on consumers. This dissertation explores the manifest content properties of cosmetic surgery advertisements over a 20 year period, as well as consumer use and interpretations of such advertising, using social comparison theory and the Sarwer model as frameworks. Stage one of the study analyzes the appeals, physical characteristics, human model characteristics, physician characteristics, risk information and inducements within 1,857 cosmetic surgery advertisements placed in city magazines from 1985 to 2004. Among the findings: promotional activity increased significantly over time; most advertisements employed rational vs. emotional appeals; a surprisingly low percentage included risk information; the use of monetary incentives increased over time; and most ads responsibly portrayed before and after photos and avoided exploiting fears, anxieties or other emotional vulnerabilities. Stage two of the study involved in-depth interviews with women about their use of cosmetic surgery advertising, confirmation or disconfirmation of expectations set by advertising, and perceptions of cosmetic surgery advertising vs. to other types of physician advertising. The findings: cosmetic surgery advertising was used early in the information search and played a relatively minor role compared to other information sources; it was used primarily for awareness of physicians in their market, their credentials, and new cosmetic surgery procedures; and it helped set expectations for both process and appearance outcomes. Ads with before and after photos were considered the most persuasive while ads that ignored the impact of individual differences on appearance outcomes, made life-changing promises, or failed to disclose when a model was not a patient were considered to be unethical. In addition, participants neither recalled nor expected to see risk information in ads and had mixed opinions on how risk information might impact physician credibility. Methodological limitations are presented, followed by suggestions for advancing cosmetic surgery advertising research.