Women's agency-their ability to make conscious choices and to act on them-is a central consideration in feminist theories of cosmetic surgery. Several key issues in this longstanding debate are how much external or coercive influence women experience (or acknowledge) in their choice to pursue surgery, whether they are aware of sexist ideology more so than non-recipients, and whether their choice to pursue surgery exemplifies a strong sense of self worth. To test this agency hypothesis, we draw on survey data from a volunteer sample of 202 adult women ages 19-86 years from the southern California region in the U.S. to compare cosmetic surgery recipients to non-recipients across these key sociocultural and personal domains. Results reveal that cosmetic surgery recipients were more likely to have friends who had undergone cosmetic surgery, endorsed more covert sexist beliefs, exhibited greater media usage, and had higher household incomes, than non-recipients. Recipients also evidenced lower ratings in global self-esteem than nonrecipients. These findings challenge some of the notions attendant to agency claims, and engage with conceptions of autonomy introduced in the feminist philosophical literature.