The Link Between Breast Surgery and Self-Esteem, According to a Plastic Surgeon

When it comes to aesthetic breast surgery, there are many more options than just implants. Whatever the procedure, it should be personalized, and expectations should be communicated and understood. New York plastic surgeon B. Aviva Preminger, MD shares information to know for anyone who may be considering breast surgery.


Women’s self-esteem is often intrinsically linked to how they see themselves. In your experience, how big of a role do breasts play in women’s self-esteem and sense of femininity?

“Women’s breasts are often intrinsically tied to how they see themselves because the female breast has always been a potent symbol of beauty, motherhood, and vitality. Women’s breasts also undergo so many changes during their lifetimes because of hormonal changes, fluctuations in weight, pregnancy, and breastfeeding. Many women see the loss of volume and sagging that can come with these changes as a sign of aging and associate it with a loss of femininity and sexual attractiveness. Some women simply feel that they were always short-changed on breast volume and the feminine associations that come with full breasts. Other women complain of too much breast volume that interferes with exercise and causes back and shoulder pain and prevents them from wearing fitting clothing and makes them look top-heavy.”

What breast procedures do people commonly seek to boost self-esteem?

“Many women seek breast augmentation with either implants and or fat to increase volume and restore breast fullness or to help create cleavage. Some of these women also require a lift, and sometimes a lift without an implant is sufficient to restore fullness and reposition the breast tissue. Other women seek smaller breasts to help improve their self-esteem after a lifetime of being self-conscious about their large breasts.”

How do breast reductions versus breast lifts or augmentations effect self-esteem differently?

“Women looking to have a reduction often feel limited in activity by their large breasts and may have medical complaints such as back and neck pain or skin irritation. Patients with smaller breasts are spared these complaints, however both often feel limited in the types of clothing they can wear and feel a restored sense of confidence when the problem is addressed.”

What do you tell patients who are hoping to get a self-esteem boost following a procedure?

“Women who have breast surgery, particularly my breast reduction patients, are some of the happiest patients in my practice. My breast reduction patients often wonder why they waited so long to get the procedure done.”

How do back and neck pain, posture issues, and other struggles that come with larger breasts play into self-esteem? How are these issues remedied by breast surgery?

“The removal of the excess breast tissue is weight lifting for women who have breast reductions. They feel lighter after the procedure and often lose additional weight because they can now exercise without having to wear multiple bras and minimizers. They also find that they look thinner and can wear clothing that they could never wear prior to surgery because it did not fit or was too tight or inappropriate to wear due to their large breasts.”

What trends are you seeing now in breast surgeries?

“I think there is an increased desire for patients to have a natural appearance, so I often combine fat with implants or try to use the patient’s own tissue to create volume. We also have newer implants with improved safety profiles and offer patients internal mesh if needed to help with long-term support and longer lasting results. I also see many patients adding surgical reduction or removal of axillary or accessory tissue in their underarms to help them feel more comfortable wearing sleeveless dresses and tops.”

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