The Impact of Breast Reduction Surgery on Mental Health and Well-being: A Systematic Review

Abstract Background Breast reduction (reduction mammoplasty) aims to enhance physical appearance and body function improvement. Beyond its cosmetic purpose, growing evidence suggests that these interventions significantly influence psychological health, self-esteem, and overall well-being. However, concerns remain regarding the ethical, psychosocial, and medical implications of such procedures. Objectives This systematic review aimed to evaluate the impact of breast reduction on the psychological health, body image, self-esteem, sexual function, and overall quality of life of women undergoing these procedures for purely cosmetic reasons. Methods Following PRISMA guidelines, a comprehensive search was conducted across PubMed, Embase, and Cochrane Library up to September 2025. Eligible studies included adult females (≥18 years) who underwent breast reduction surgery primarily for cosmetic purposes. Studies assessing psychological, psychosocial, or quality-of-life outcomes were included, while those involving breast reconstruction for cancer or non-cosmetic indications were excluded. Data extraction and quality assessment were independently performed by two reviewers using the ROB 2.0 tool. Results Out of 442 records identified, seven studies met the inclusion criteria. The findings consistently demonstrated that reduction mammaplasty led to significant improvements in self-esteem, body image, and mental health, with marked reductions in depression and anxiety levels (p < 0.05 across studies). Patients reported enhanced sexual satisfaction and function, as well as substantial gains in quality of life. Physical benefits such as pain relief and increased functional capacity further reinforced these psychological gains. Conclusions Reduction mammaplasty, produces meaningful psychological and quality-of-life benefits in women with body dissatisfaction or symptomatic hypertrophy. Improvements in body image, self-esteem, and mental well-being are consistently reported across studies. However, these benefits must be balanced against surgical risks and ethical considerations, emphasizing the need for comprehensive preoperative psychological evaluation and counseling.