Low self-esteem is defined as having no confidence. It is when people feel like they are not enough and wish something about them would disappear. However, just because someone does not love something about themselves, it does not necessarily mean they feel worthless. A person can hate the way their nose looks or how their lips are thin and at the same time feel confident about themselves. So, does getting plastic surgery mean having low self-esteem? Does making changes to the body create confidence, or does it mean the person is insecure?