This study investigated effects of appearance-based rejection sensitivity (Appearance-RS) - the dispositional tendency to anxiously expect rejection based on one's appearance - in a sample of 133 American college students. Participants were randomly assigned to write an essay about either a negative or positive appearance comment they had received in the past. Compared to participants with lower Appearance-RS, those with higher Appearance-RS felt more rejected and expressed greater interest in cosmetic surgery after recalling a negative versus positive appearance comment. Content analysis of the essays revealed that negative appearance comments were most often made in reference to one's body weight/shape/size; positive appearance comments were most often made in reference to one's overall appearance. Peers/friends/romantic partners were the most frequently cited source of both positive and negative appearance comments. Overall, this research suggests that the interaction between the person and the situation is important to consider when predicting cosmetic surgery interest.