By Denise Mann
Reviewed By Michael Smith
Emily was always made fun of for her rather large nose. Then the summer before her senior year of high school, she got a nose job. All of a sudden, the same boys who called her Pinocchio and some other not-so-nice names were asking her out.
Sixteen-year-old Kimberly's triple D breasts may have gotten the boy's attention, but they made exercise -- and even walking -- painful. But a breast reduction has changed her life. Now she can exercise freely -- even jog without the back and neck pain that her large breasts once caused.
For teens like Emily and Kimberly, cosmetic surgery can be a godsend. But for others such as those who are urged by their parents, it may be ill-advised, prominent plastic surgeons tell WebMD. The key is making sure that the teen is emotionally and physically mature enough to undergo the chosen procedure.
Chemical Peels to Liposuction
For a whole slew of reasons -- from its relative safety to its acceptance in society -- plastic surgery is popular among people of all ages. The number of kids 18 and under having plastic surgery rose from just under 60,000 in 1997 to nearly 225,000 in 2003, according to statistics compiled by the American Society for Aesthetic Plastic Surgery.
A report that looked at eight years' worth of data on teenagers found that the most common cosmetic procedures in teens are chemical peels and microdermabrasion to treat acne, laser hair removal, nose jobs, ear surgery, breast reduction, breast enlargement, chin augmentation, and liposuction to remove excess body fat.
In 2000, about 50,000 teens had chemical peels, and more than 21,000 underwent microdermabrasion. More than 15,000 teens aged 18 or younger had nose jobs, and almost 12,000 underwent procedures called otoplasty or ear surgery for protruding ears.
Male breast reduction was done in more than 2,200 young men with a condition called gynecomastia or male breasts, while more than 2,100 girls in this age group had breast enlargements -- some of which are done to correct uneven breasts. Liposuction to reduce fat deposits in the trunk or chin was done in more than 6,200 people aged 18 or younger in 2000.
Why Teens Turn to Plastic Surgery
There are many reasons that plastic surgery is increasingly accepted among all ages, from teens on up.
"First, the surgery is safe; there are very few significant complications. Second, our society places a high premium on physical attractiveness and rewards those who are slender, youthful and handsome," conclude study authors Mary H. McGrath, MD, MPH, and Sanjay Mukerji, MD, plastic and reconstructive surgeons at the George Washington University Medical Center in Washington, in a recent issue of the Journal of Pediatric and Adolescent Gynecology.
"Third, we live in a culture that emphasizes competition and legitimizes self-improvement as a way to gain a competitive edge and lastly, plastic surgery lives up to its expectations."
In places like Brazil, sometimes called the new capital of plastic surgery, nips and tucks are fairly common -- especially among beauty pageant contestants. Juliana Borges, 22, the new Miss Brazil who competed in the recent Miss Universe pageant, had plastic surgery four times and underwent 19 smaller cosmetic procedures. Borges had liposuction, chin surgery, fixed her nose and ears, and also had breast implants. In fact, some were suggesting that if she did win the Miss Universe title (Miss Puerto Rico won), the accolades should really have gone to her plastic surgeon.
Is Your Teen Right for Plastic Surgery?
When it comes to teens, part of the challenge is deciding on appropriate candidates who can not only benefit from cosmetic surgery but also understand its limitations.
"Teens who are encouraged to have surgeries by families and friends when they are not interested are poor candidates for plastic surgery," Malcolm D. Paul, MD, president-elect of the American Society for Aesthetic Plastic Surgery and a plastic surgeon in Newport Beach, Calif., tells WebMD.
"The motivation should come from within and not without," he says. "It has to be for the right reasons, not because mom and dad feel that it's something a child should do."
Darrick Antell, MD, a New York plastic surgeon, says before he performs many procedures on a teenager he tries to make sure that the concern is consistent.
"Is it the nose one week, the ears the next, and the breast the following week?" he says. "We want to be sure it is a consistent complaint."
Antell says he also likes to determine whether the concern is self-motivated in his teen patients. "If a parent dragged them in, that would send up a lot of red flags for me," he tells WebMD.
"Some parents in this day and age want everything they can have for their child, from a new stereo to a new car and sometimes a new nose. This may not necessarily be appropriate."
More teens may be undergoing cosmetic surgery today because their parents have undergone it, he says. The parent's attitude may be "I had it done and my daughters inherited the nose I didn't want."
Some procedures may be inappropriate for teens. "I think it would be a rare case where you would do liposuction on a teenager because a lot of teens grow out of their baby fat," Antell says. Breast enlargement, unless it is to make sure both breasts are symmetrical, may also be inappropriate.
"You want to make sure the breast is fully developed before performing breast augmentation," he says.
Breast reduction, however, may make dramatic improvements of quality of life if the teen can't play sports. "Very large breasts can be a hindrance to playing sports and maneuvering, and some people may experience neck, back, and shoulder pain as a result. Breast reduction surgery is a very satisfying operation in the appropriate teen patient."
Nose jobs too can make a tremendous difference in the right teen patient.
Teens who make good candidates for nose jobs are those "with noses with lumps, bumps or hooks; too big or too high; or with a poor angle between the nose and upper lip," according to McGrath and Mukerji.
People with minor imperfections are not good candidates, they note.
How to Get the Most Out of Plastic Surgery
According to American Society of Plastic Surgeons, the most rewarding outcomes are expected when the following exist:
- The teenager initiates the request. While parental support is essential, the teenager's own desire for plastic surgical improvement must be clearly expressed and repeated over a period of time.
- The teenager has realistic goals. The young person must appreciate both the benefits and limitations of plastic surgery, avoiding unrealistic expectations about life changes that will occur as a result of the procedure.
- The teenager has sufficient maturity. Symptoms of emotional distress must be reduced to a level that will permit the teenager to tolerate the discomfort and temporary disfigurement of a surgical procedure. Plastic surgery is not recommended for teenagers who are prone to mood swings or erratic behavior, who are abusing drugs and/or alcohol, or who are being treated for clinical depression or other mental illness.
The most important part of having plastic surgery is the surgeon you choose. When choosing a surgeon, make sure he or she is board-certified in plastic surgery and has privileges to operate in a hospital (even though a majority of cosmetic procedures are done in office), Antell says.
Originally published May 25, 2001.
Medically reviewed Oct. 4, 2004.
SOURCES: Journal of Pediatric and Adolescent Gynecology. American Society for Aesthetic Plastic Surgery. Malcolm D. Paul, MD, president-elect, American Society for Aesthetic Plastic Surgery. Darrick Antell, MD, plastic surgeon, New York.
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