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Beauty and elegance: value co-creation in cosmetic surgery tourismThis study presents an emerging trend in medical tourism, cosmetic surgery tourism (CST). We explore tourists’ perceptions of CST for medical service quality as an antecedent to tourists’ emotional attachment, trust, and intentions to visit, which is underexplored in CST. This study examines the mediating role of value co-creation in influencing behaviors of CST-seeking tourists to experience a better quality of life. Using a sample drawn from 279 tourists, comprised of Australian, Japanese, and Chinese nationalities at two international airports in China, findings show that perceived medical service quality positively influences tourists’ emotional attachment, trust, and intentions to visit directly and through the mediating role of value co-creation across the three nationalities. CST-seeking tourists’ inputs in value co-creation may positively influence their behaviors, which are vital antecedents to promoting CST business. Implications for future research are discussed.