Cosmetic surgery media coverage has become common in recent years, with surgery featuring in advertising and reality TV. Concerns have been expressed by the American and British Associations for Plastic Surgery about the nature of this coverage, particularly with respect to the impact on adolescents (ASPS, 2004; BAAPS, 2004). This study was the first to investigate adolescent girls’ responses to a cosmetic surgery TV show using an experimental design. Girls (N = 99) aged 15 to 18 (M = 16.6) years were randomly allocated to one of three conditions: a cosmetic surgery TV show, which (1) mentioned risks associated with surgery, (2) did not mention risks, or (3) to the control condition, a home makeover show. Results showed that exposure to cosmetic surgery shows resulted in girls reporting more dissatisfaction with their weight and appearance, but no changes were observed in attitudes toward cosmetic surgery. Girls’ responses to cosmetic surgery shows varied according to their materialistic values and the extent that they derived self-worth from their appearance. Results suggest that cosmetic surgery reality TV can be damaging to adolescent girls’ body image and that there is a need for research to consider factors that may affect how girls respond to such shows.