INTRODUCTION: Oncoplastic breast surgery (OPS) with immediate symmetrization is commonly performed. However, its impact on patient-reported outcomes (PROs) remains uncertain. METHODS: Patients with stage 0-III breast cancer who underwent OPS (including oncoplastic breast conserving surgery, or nipple- or skin-sparing mastectomy) at a Swiss university hospital between 01/2013-12/2023 who completed a postoperative BREAST-Q questionnaire were identified from a prospectively maintained database. A generalized linear model was used to detect differences in PROs between those who underwent unilateral versus immediate symmetrizing surgery. RESULTS: Of 441 eligible patients, 333 (75.5 %) underwent unilateral OPS, while 108 (24.5 %) underwent bilateral OPS. Median time to PRO assessment was 35.1 months (Q1-Q3 13.4-49.5). No differences in PROs were identified between patients who underwent unilateral versus bilateral OPS. Short-term surgical morbidity was more common in patients who underwent symmetrizing surgery, which negatively impacted PROs. CONCLUSION: The present study did not demonstrate any impact of immediate symmetrization on PROs.