Background: Psychological characteristics could significantly impact applications for cosmetic surgery as well as precognition and satisfaction with surgery. The present study aimed to investigate the relationship between perfectionism, early maladaptive schemas, attachment styles, and body image concern by the mediating role of self-esteem in cosmetic surgery applicants. Methods: This was a predictive correlational study. The statistical population of the study included all female applicants for cosmetic surgery referring to cosmetic surgery centers in Tehran City, Iran, in 2020. A sample size of 400 women was selected based on Klein’s model (2016). The required data were collected by Rosenberg Self-Esteem Scale (RSES) (1989), Multidimensional Perfectionism Scale (MPS), Young Schema Questionnaire (YSQ-S3), Adult Attachment Scale (AAS), and Body Image Concern Inventory (BICI), and analyzed using Pearson correlation coefficient and structural equations in SPSS and AMOS. Results: The obtained results signified a significant relationship between perfectionism, early maladaptive schemas, attachment styles, self-esteem, and body image concerns (P<0.01). Furthermore, the modified model presented a good fit (The Root Mean Square Error of Approximation (RMSEA) =0.061, GFI=0.989, IFI=0.987, P<0.05); the indirect paths of perfectionism, early maladaptive schema, and attachment styles through self-esteem were also significant. Conclusion: The evaluated model indicated a good fit; thus, it can play an essential role in recognizing the factors affecting the body image concerns of female cosmetic surgery applicants.