Prior research has reported a psychological impairment in patients seeking cosmetic surgery. However, the role of other variables such as contingencies of self-worth and self-knowledge has been ignored. Hence, the aim of this study was to examine new psychological structures, contingencies of self-worth, and self-knowledge among patients seeking cosmetic surgery. Eighty patients (47 female and 33 male; mean age = 28.98, SD = 8.32; 40 seeking cosmetic surgery and 40 seeking surgical treatment) were randomly recruited from the Shahid Motahhari clinic in Shiraz, Iran. The patients completed the Contingencies of Self-Worth Scale, Integrative Self-Knowledge Scale, Subjective Vitality Scale, and Depression Anxiety Stress Scale-21. The results showed that, compared to the surgical treatment group, self-worth in patients seeking cosmetic surgery was found to depend on their appearance and the approval of others. Further, the self-knowledge in patients seeking cosmetic surgery was lower than that of patients seeking surgical treatment. In addition, there were no significant differences between the two groups in vitality, depression, anxiety, and stress. It can be concluded that patients seeking cosmetic surgery have lower self-knowledge and their self-esteem depends on their appearance and the approval of others.