Introduction: Ostomy surgery can alter body image, daily functioning, self-esteem, and self-perception, making adjustment important during young adulthood. However, evidence on self-concept among young Filipino adults with an ostomy remains limited. Objective: This study explored self-concept and its influencing factors among young Filipino adults living with a colostomy and developed a preliminary framework. Methods: A qualitatively driven embedded mixed-methods design was used. Six participants aged 18–39 years were purposively recruited. The quantitative component used an 18-item questionnaire adapted from Goñi et al. (2011) to assess self-fulfillment, autonomy, emotional self-concept, and ethical self-concept (honesty), while semi-structured interviews comprised the qualitative component. Quantitative data were summarized using weighted means, and interview data were analyzed using Braun and Clarke’s six-phase thematic analysis. Findings were integrated through a joint display. Results: Mean scores were good for self-fulfillment (M = 3.00), autonomy (M = 2.54), and emotional self-concept (M = 2.87), and very good for ethical self-concept (M = 3.50). Three themes emerged: (1) Confronting Changes in Body Perception and Daily Functioning; (2) Managing Internal and Social Burdens; and (3) Building Resilience Through Layered Support and Connections. Integration informed a preliminary framework linking self-concept with sociodemographic circumstances, physical challenges, internal and social burdens, and family, cultural, peer, and community support. Conclusion: Despite body-image, emotional, and functional challenges, participants reported favorable self-concept. Their narratives highlighted resilience, family relationships, cultural values, and peer networks as important resources during adjustment. These findings may inform culturally responsive, person-centered nursing support for young adults living with a colostomy.