# The Impact of Cosmetic and Plastic Surgery on Self-Esteem: A Systematic Review and Meta-analysis

## TL;DR

Cosmetic surgery, especially breast procedures, is linked to a moderate improvement in self-esteem, according to a review of 25 studies.

## Contribution

This study provides the first meta-analysis specifically examining the impact of cosmetic surgery on self-esteem.

## Key findings

- Cosmetic surgery significantly improves self-esteem with an overall effect size of Hedges' g = 0.43.
- Breast surgeries showed a larger effect (g = 0.59) compared to facial surgeries (g = 0.23).
- The improvement in self-esteem was small to moderate but statistically significant.

## Abstract

The global demand for cosmetic surgery continues to rise, driven largely by societal factors and personal motivations related to self-esteem and psychological well-being. Although previous reviews have examined general psychological outcomes, specific impacts on self-esteem remain underexplored. This systematic review and meta-analysis aimed to synthesize current evidence regarding the effects of nonreconstructive cosmetic surgery on self-esteem in adult patients. A systematic literature search was conducted across multiple databases, including MEDLINE, Embase, Cochrane Library, and others, from January 2005 to March 2025. Studies evaluating self-esteem before and after cosmetic procedures using validated scales were included. The methodological quality was assessed using the Effective Public Health Practice Project criteria. Data synthesis employed a random-effects meta-analyses using Hedges' g to estimate effect sizes. Twenty-five studies (n = 1502 patients) met inclusion criteria. The overall meta-analysis indicated a statistically significant improvement in self-esteem after cosmetic surgery (Hedges' g = 0.43, 95% CI, 0.13-0.73; P = .003). Subgroup analyses demonstrated a significant positive impact particularly in breast surgeries (g = 0.59; P = .006), whereas facial surgeries showed smaller, nonsignificant changes (g = 0.23; P = .268). Cosmetic surgery is associated with a small to moderate but significant improvement in self-esteem, particularly after breast procedures.

Level of Evidence: 2 (Therapeutic)