Breast Aesthetics, Motivational Factors in Surgery, and the Influence of Social Media and Pornography
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Updated: Jun 17, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Judie Vanweser1, Giuseppe Diluiso2, Lolita Perez-Nunez1
1Hôpital Erasme (Bruxelles, Belgium), Service de Chirurgie Plastique, ULB Université libre de Bruxelles, Bruxelles, Belgium.
Background:
Breast image plays an important role in a woman's identity. Breast aesthetics has strong social, emotional, and cultural connotations.
Objectives:
We aimed to understand one's breast satisfaction, what is seen as ideal, and the gap between these two facets. We also studied the influence of several factors on these conceptions, including clinical and demographic characteristics, self-esteem, social media use, and pornography. We also studied the motivational factors driving the recourse to surgery.
Methods:
An online questionnaire of 64 questions divided into 5 sections was shared on social media to all women over the age of 18. Three versions were available: French, Dutch, and English. The questionnaire was accessible for 45 days (from 12/18/2021 to 01/31/2022).
Results:
A total of 382 complete responses were analyzed. The average age was 30.6 years; the most frequent breast size was a B cup (29.06%), while the size considered ideal was a C cup (49.48%). Social media and pornography seem to influence the conception of ideal breast; the subgroup that uses them tends to choose a larger breast size as ideal. Smoking and the education level also seem to influence this conception. Furthermore, 26.96% of women would benefit from breast surgery if they did not have to consider the financial aspect.
Conclusions:
The ideal breast concept is highly dependent on regional, cultural, and religious factors. It is interesting to note the influence that other less studied factors, such as pornography, smoking habits, and social media, may have.
Level Of Evidence V:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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