Perfectionistic self-presentation refers to a desire to create an image of flawlessness in the eyes of the others and has been associated with more negative body image. We extended previous research by examining associations between perfectionistic self-presentation and breast size dissatisfaction, and also examined whether motherhood status moderated this association. A total of 484 Italian women (age M = 40.39, SD = 13.73; mothers n = 53.9%) completed measures of perfectionistic self-presentation (perfectionistic self-promotion, nondisplay of imperfection, and nondisclosure of imperfection) and breast size dissatisfaction. Preliminary analyses indicated that a majority of the sample (69.2%) reported breast size dissatisfaction, with 44.4% and 24.4% desiring larger and smaller breasts, respectively, than they currently had. Only perfectionistic self-promotion and nondisplay of imperfection were significantly correlated with breast size dissatisfaction. Both associations were additionally moderated by motherhood status, with associations being significant in non-mothers but not in mothers. Our findings suggest that motherhood may help decouple the link between perfectionistic self-presentation and breast size dissatisfaction. Future studies should assess whether this effect is due to an enhanced maternal view of breasts that emphasises nurturing and biological functions or a result of weaker investment in sociocultural norms on physical appearance.