I dont really have advice except to keep talking to your therapist or find a new one or try a new type of therapy if the current one isnt working for you. From what i have read and gather there arent too many happy stories in the sex industry.

With advertizing and television shows or even porn movies depicting people with perfect bodies and faces and teeth, there are many people these days who are unhappy with their bodies or faces ot teeth because they feel like they cant measure up. You arent alone there. Its an impossible standard for most of us to live up to.

Plastic surgery, such as breast enhancement has its own risks. Breast implants have been implicated in autoimmune diseases and even some cancer. Anything foreign you put in to your body, your body will react to. Of course not everyone gets sick but there are a number of people who do. Its a decision you would have to make and weigh the benefits vs. the risks for different plastic surgeries. Plastic surgeons will never tell you about this.

IM not the most qualified person to talk to you about self esteem or how to strengthen it. I hope some of the women here weigh in with their experiences or thoughts on it.
Keep working on this with your therapist and dont rush into anything.