Adolescents and Cosmetic Surgery

n an earlier article about breasts and self-image during adolescence, we looked at a couple of news articles about the increase in cosmetic surgery for young girls eager to improve their bodies. Since writing that article, I’ve found three press releases from the American Society for Aesthetic Plastic Surgery (ASAPS) that present the other side of the issue.

(ASAPS is devoted to education and research in cosmetic surgery. Its members are plastic surgeons certified by the American Board of Plastic Surgery.)

In a release dated January 3, 2000, ASAPS says that media reports of “a significant increase in teen cosmetic surgery are not supported by current statistics”:

  • Results of a December 1999 survey of a representative sample of member surgeons of ASAPS show there has been no unusual increase in the number of teens seeking or receiving aesthetic surgery over the last 12 months.
  • Statistics compiled by ASAPS in 1997 and 1998 show an increase of only 0.2% in the total number of procedures performed on individuals 18 and younger. These individuals represented 2.9% of the total number of cosmetic procedures performed in 1997 and 3.1% of procedures in 1998.
  • Comparison of additional statistics compiled by the American Society of Plastic Surgeons (ASPS) for 1992 and 1998 shows that the percent of liposuction and breast augmentation procedures performed by board-certified plastic surgeons on those 18 and younger had either remained constant (liposuction, 1%) or had gone down (breast augmentation was 3% of the total procedures in 1992 and 1% of the total in 1998).
  • Surveys of public confidence in cosmetic plastic surgery have consistently shown growing acceptance of elective procedures, yet data so far conclude that those 18 and under are not seeking these procedures in disproportionately rising numbers.

The ASAPS further identifies the following procedures as “among those most commonly performed for patients 18 years of age and younger”:

  • Rhinoplasty: Nose reshaping is the most common aesthetic procedure requested by teens. It can be performed when the nose has completed 90% of its growth, which can occur as young as 13 or 14 in girls and 15 or 16 in boys.
  • Otoplasty: Cosmetic ear surgery can be performed in children as young as 5.
  • Breast reduction: Can help girls as young as 16 with overly large breasts, who may experience back and shoulder pain as well as restriction of physical activity.
  • Correction of breast asymmetry: Surgery can help girls as young as 16 when one breast significantly differs from the other either in size or shape.
  • Treatment of gynecomastia: In some teenage boys, excessive breast development can become a significant psychosocial problem. Excess tissue can be removed in boys as young as 16.
  • Chin augmentation: Often addressed with rhinoplasty to achieve facial balance.
  • Lipoplasty (liposuction): Recommended for patients of normal weight with localized fat deposits resistant to diet and exercise, often a hereditary condition. Those 18 and younger represented 1.4% of the total number of procedures performed in 1997, and 1.3% in 1998.

Finally, the ASAPS says that while the overall number of aesthetic (cosmetic) surgeries has increased, the rate of teens having cosmetic surgery has remained constant. “Additionally, most experts agree that for appropriately selected teenage patients, cosmetic surgery can have a positive impact on physical and emotional development.”

The society offers the following guidelines about teens and cosmetic surgery:

  • Assess physical maturity: Operating on a feature that has not yet fully developed could interfere with growth or negate the benefits of surgery in later years.
  • Explore emotional maturity and expectations: The young person should appreciate the benefits and limitations of proposed surgery and have realistic expectations.
  • Check credentials: State laws permit any licensed physician to be called a “plastic” or “cosmetic” surgeon, even if not trained as a surgeon. Look for certification by the American Board of Plastic Surgery. If the doctor operates in an ambulatory or office-based facility, the facility should be accredited. Additionally, the surgeon should have operating privileges in an accredited hospital for the same procedure being considered.
  • Explore risks and expected recovery times: Teens and their parents should understand the risks of surgery, postoperative restrictions on activity, and typical recovery times.