Cosmetic Plastic Surgery & Young Adults

Cosmetic Surgery and Your Teen - Talking to Young Adults about Cosmetic Surgery

Updated September, 2011

Overview

In discussing plastic surgery and other cosmetic procedures with young adults, ages 13-19, a different set of factors related to self-esteem come into play.

It's imperative to understand why a teen wants cosmetic surgery, and then, if the decision to move forward is made, to guide their expectations to be realistic about both the process and its likely outcome.

For most parents, this topic presents a serious dilemma since their first inclination is to simply say, "No." While parents are understandably worried about the danger to their child, this is not a request that should be taken lightly and most definitely not to be ignored.

Generally serious issues of self-image and self-esteem often lie at the heart of a teen's request to have a cosmetic procedure. These issues must all be fully addressed.

Parents should understand that there are circumstances under which cosmetic procedures for teenagers are both appropriate and life-enhancing. However there are as many bad reasons to agree to allow a young adult to seek cosmetic surgery, as there are good ones.

Table of Contents

Cosmetic Plastic Surgery for Young Adults Cosmetic Surgery and Your Teen - Talking to Young Adults about Cosmetic Surgery

• Overview
• Introduction to Plastic Surgery for Young Adults
• The Overall Popularity of Cosmetic Procedures
• Talking to Young Adults About Cosmetic Surgery
• Step One: Research
• Educate Yourself Online
• Step Two: Evaluate the Specific Teen
• Step Three: Interview Surgeons
• Questions to Address In Surgery Consultation
• A Few Words on Plastic & Cosmetic Board Certification?
• Important Considerations: For or Against Proceeding
• If the Decision is No
• If the Decision is Yes
• A Few Words on Health Insurance, Financing & Cost
• Health insurance
• Medical Financing
• Cosmetic Surgery Cost
• Procedures Generally not Recommended for Young Adults
• Common Cosmetic Procedures for Young Adults
• Protect Your Teen from False Expectations
• Adhere to the Letter of Informed Consent
• Summary
• Read More - Additional Useful Information
• Sources

Introduction to Plastic Surgery for Young Adults

When teenagers ask their parents to pay for or to allow them to undergo some form of cosmetic surgery or non-invasive cosmetic augmentation, the motivation is generally even more directly tied to self-esteem than is the case with adults.

Adolescence is an awkward time of coming into your own. Teenagers often see perceived physical flaws as glaring and life-destroying. Interestingly, adults generally seek cosmetic surgery to make themselves stand out. Teenagers, on the other hand, desperately want to blend in with their peers.

Consequently, while there are many bad reasons to agree to allow a young adult to seek cosmetic surgery, there are just as many good ones.

If the procedure will allow the teen to have greater self-confidence and self-esteem, and to overcome problems with social withdrawal and isolation, the benefits will likely far exceed any potential negatives.

In 2010, the American Society of Plastic Surgeons reported 219,000 surgical procedures on individuals ages 13 to 19 for a number of common reasons.

The Overall Popularity of Cosmetic Procedures

Given the overall popularity of cosmetic procedures, it is not surprising that more teens are asking to undergo some kind of augmentation, restructuring, or reduction. Cosmetic surgical procedures have become increasingly popular in the United States over the past ten years, jumping from 932,649 surgeries in 2000 to 996,982 in 2010.
Worried parents should actually take that as a positive. There are more highly skilled surgeons practicing solely in this field, and more medical facilities dedicated exclusively to cosmetic surgery than ever before. This equates to a greater likelihood of achieving a thorough evaluation and consultation and a positive outcome, if the decision to move forward is made.

Of the operations performed annually, the most popular are various kinds of breast and lip augmentations, followed by tummy tucks, eyelid surgery, face lifts, and nose jobs. The use of Botox is far and away the most frequently performed minimally invasive procedure, going from just 118,452 injections in 2000 to 1,969,718 in 2010.

Of this group, it is most likely teens would ask for a nose job. Surgeons who routinely perform this procedure have extensive before and after comparisons, and utilize highly advanced software for pre-surgical consultations, which will help to assure both the teen and the parents of a favorable result. Since the parents themselves will likely have some degree of familiarity with cosmetic procedures either on a personal level or because they know someone who has gone through the process, pre-surgical consultations can be carried out on a more informed level.

These surgeries are no longer the purview of the rich and famous only. Familiarity does not, however, mean that parents know how to talk to their teens about cosmetic changes, only that they are somewhat less likely to be “thrown" by the idea. Going into the consultation, it is crucial to remember that as a general rule, teens are not good at setting realistic expectations, an inability that can set them up for bitter disappointments.

This is an area where parents can and should safeguard their teen's best interests with rigorous questions about the surgeon and the surgery itself.

Talking to Young Adults About Cosmetic Surgery

For most parents, this topic presents a serious dilemma since their first inclination is to simply say, “No." While parents are understandably worried about the danger to their child, this is not a request that should be taken lightly and most definitely not to be ignored.

Generally serious issues of self-image and self-esteem often lie at the heart of a teen's request to have a cosmetic procedure. These issues must all be fully addressed.

Parents should understand that there are circumstances under which cosmetic procedures for teenagers are both appropriate and life-enhancing. However there are as many bad reasons to agree to allow a young adult to seek cosmetic surgery, as there are good ones.

Step One: Research

When a teen asks for a cosmetic procedure, the parents' first reaction should be calm. Agree to research the procedure and then follow through on that promise. There are many good resources at your disposal:

Educate Yourself Online

American Society of Plastic Surgeons at plasticsurgery.org:

• This website offers a number of comprehensive resources for parents dealing with their teens and cosmetic surgery including "Policy Statement: Breast Augmentation in Teenagers," the society's official statement on selecting candidates for breast surgery who are less than 18 years of age.
• Also refer to the companion resource, "Plastic Surgery for Teenagers Briefing Paper," which explores, among other topics, which teenagers are not well-suited to undergo cosmetic procedures.
• Available videos include a segment from The Dr. Phil Show interviewing a Teen Who Wants Breast Augmentation, and a similar interview about Teen Rhinoplasty.

Even if these resources do not cover the specific procedure being considered, they will help parents begin to understand the psychological reasons that lie beneath the request for the surgery.

• GirlsHealth.gov offers extensive resources to help young girls, "Be Healthy. Be Happy. Be You. Beautiful." The section on cosmetic surgery details popular procedures and the risks involved, as well as addressing the underlying emotional unhappiness that drives girls to want to change their bodies.
• Plastic Surgery and the Teenage Patient" is an article by M.H. McGrath and S. Mukerji, both with the Division of Plastic Surgery and Reconstructive Surgery at The George Washington University Medical Center in Washington, D.C. It discusses trends in plastics surgery for teenagers over an eight-year period, examining cultural influences and societal concepts of beauty.
• Elective Plastic Surgical Procedures in Adolescence" by M.H. McGrath and W.G. Schooler, with the Division of Plastic Surgery, Department of Surgery, University of California at San Francisco, is an examination of the influence of perceived body image on the motivation to seek plastic surgery, including the role the media plays in shaping our concept of “beauty."
• Have Your Say: Children and Young People Using Cosmetic Surgery and Solariums in Queensland" examines the increase in cosmetic surgery procedures and cosmetic tanning in young people in Australia, including invasive procedures like face-lifts, tummy tucks, lipsuction, and breast enlargement, as well as collagen and Botox injections among other non-invasive "treatments."
• Body Image: Teenagers and Cosmetic Surgery" is a reprint at OurBodiesOurselves.org of an article by Diana Zuckerman that appeared in March 2005 in Virtual Mentor, the online ethics journal of the American Medical Association. Zukerman explores a crucial factor in the plastic surgery for teenagers debate, "Cultural phenomena such as surgical makeovers on numerous television programs . . . make it increasingly difficult to agree on what constitutes a 'normal' appearance . . .."
• The influence of cultural phenomenoa and reality TV and the effect on teen self-esteem is also explored extensively at Education.com in the article, “When Your Teen Wants Plastic Surgery," which points out:

"To a parent, every child is beautiful. But when kids hit their teens, they often become obsessed with physical imperfections – and in our media-drenched society, that can mean anything from a slightly crooked nose to a belly that isn't concave. It's no surprise that more and more teens are turning to plastic surgery to “fix" the flaws that bother them. Shows like “Extreme Makeover" and magazine features about celebrities have made cosmetic surgery seem like a rite of passage."

Step Two: Evaluate the Specific Teen

Any teen who wants to have a surgical cosmetic change must have the necessary emotional maturity to:

• discuss specifically what will be done to their body
• understand the limits of what the procedure can accomplish
• face the physical discomfort involved
• and meet the needs of a successful recovery

It is also possible that a teen will not have achieved the growth milestones necessary for the work to actually be performed. Most cosmetic procedures cannot take place until the body has stopped growing. Younger candidates for cosmetic procedures must be prepared to wait.

Step Three: Interview Surgeons

When both the parents and the teen understand the basics well enough to proceed with at least exploring surgery as a possibility, the parents should contact and interview several surgeons.

Initial discussions over the phone are fine, but when the list of candidates has been narrowed to two or three, in-office interviews are a must.

Questions to Address In Surgery Consultation

• Are you board certified, from which organizations? Other credentials?
• Do you have hospital privileges to perform this procedure?
• Ask to see the surgeon's educational and training credentials.
• Please provide testimonials and after & before pictures from satisfied patients on whom you have performed this procedure?
• Ask for a list of former patients who are willing to be contacted as references.
• Request before and after photographs of patients of the same age and body type who have undergone the procedure being considered.
• What are the risks associated with this procedure?
• What is your complication rate with this procedure?
• How many of these types of procedures have you performed?
• Ask the surgeon to run through a timeline of what will happen and to identify milestones in the preparation and recovery regimens.
• Get a list of all medications that will be used, including anesthesia, and research interactions and side-effects.
• What is the exact breakdown of all fees for this procedure?
• Will there be any other costs involved?
• Will you yourself be performing the procedure?
• What other medical staff will assist with the procedure?
• What kind of result is realistic that I expect given the unique prerequisites?
• How long can we expect the result to last?
• Will she/he have to undergo the procedure again?
• How long will the recovery take?
• What can we expect?
• When will we see the full result of the surgery?
• Is there anything in the medical history that you feel disqualifies him/her as a candidate for this specific procedure?

Allow the teenager to participate in all discussions about the viability of the procedure. Don't send them out of the doctor's office. The discussions involve a surgery that will be performed on their body, not yours. They have a right to know everything. Encourage them to ask their own questions and ensure that those questions are answered fully to your satisfaction and theirs.

Also, be aware that teenagers are naturally suspicious. If parents come out of a private consultation with the doctor and say, "The surgery is off because you're still growing," they may well think that's just a more complicated way to say, "No, you can't do this because I don't want you to."

A Few Words on Plastic & Cosmetic Board Certification

The more experienced the plastic surgeon is, the better the chances are for the best results of the surgery.

Using a board-certified surgeon ensures that your procedure will be conducted by someone who has shown that they have the knowledge and experience required to safely and adequately practice medicine in that specific field.

Because of the increase in requested procedures, there has been an increase in the amount of surgeons who perform procedures without the proper training or licensing. Recognizing this, the medical community has established certain criteria and procedures to establish those surgeons allowed to perform cosmetic surgeries.
Board certification is the process established by a certain authority that a medical professional has achieved the education and experience necessary to certify them to practice medicine in a specific field. To name two important organizations.

Board Certifying Associations

These organizations require ABPS Board Certification from the surgeons in order for them to be members.

American Society for Aesthetic Plastic Surgery (ASAPS)

is the most prestigious association for plastic surgeons. They strongly believe in the patient’s right to know the credentials of their surgeon, and they have very strict guidelines of obtaining and maintaining membership. Only one quarter of the applicants are accepted into the association.

American Society of Plastic Surgeons (ASPS)

is perhaps the topmost organization for patient information. They publish literature and provide information on their website so patients considering plastic surgery can educate themselves on the various procedures.

Please note that the only two associations that require members to be board-certified plastic surgeons are the American Society of Plastic Surgeons (ASPS) and American Society for Aesthetic Plastic Surgery (ASAPS).

The more experienced the surgeon is, the better the chances are for the best results of the surgery. And naturally, the more experienced the plastic surgeon is, the more sought after are his or her services.

Read more: Plastic & Cosmetic Surgery Organizations & Associations Explained

Important Considerations: For or Against Proceeding

If the surgeon is against the procedure, make sure the doctor lays all the reasons for the opinion out on the table for the teen to see in clear language.

It is extremely important that the young person not feel discounted or diminished by the decision not to proceed.

If the Decision is No

If the decision is not to proceed, be able to list for your teen the specific reasons why the procedure is not a good idea. Show specific proof. If, for instance, the teen has not grown sufficiently to undergo the operation, make it clear the option is not off the table and that the teen will be re-evaluated for the procedure when a specific amount of time has passed.

If the surgeon is against the procedure, make sure the doctor lays all the reasons for the opinion out on the table for the teen to see in clear language.

If the Decision is Yes

When all the real, medical considerations have been addressed, including:

• the teen's overall health,
• the potential for complications,
• an estimate of the success of the procedure,
• an assessment of the teen's physical and emotional maturity
• and then, you have to sit down and think about the money involved.

Health Insurance, Financing & Cost

Health Insurance

Health insurance does not pay for cosmetic surgery. You may have a case for benefits if the procedure corrects a physical symptom that arguably improves the health of your teen, but be prepared for a fight. Especially in light of the recent health care reforms, and the push back from the insurance industry, carriers are not inclined to pay out any money for this kind of work.

Ask the doctor and the medical facility that will be used to provide an itemized estimate of the total costs of the procedure and compare that, line by line, to the final bill you receive.

Medical Financing

Medical financing for plastic and cosmetic surgery is what is known as an unsecured loan. Unsecured loans typically have higher interest rates due to the increased risk for the lender, and are dependent upon your credit score. Most surgeons accept or offer themselves financing options for their plastic surgery procedures.

More information; Extensive Medical Financing Guide

Cosmetic Surgery Cost

The cost of plastic surgery is dependent on a few factors, cost for the actual procedure, amount of work involved, medications, anesthesia, medical tests, surgical garments or other miscellaneous fees related to the surgery. Be sure you get an itemized estimate of the total costs from your surgeon.

More information on cosmetic surgery cost: National Average Plastic Surgery - Break Down of Cost per Procedure 2010

Procedures Generally Not Recommended for Young Adults

Cosmetic surgeries generally not recommended for teenagers and young adults:

• Liposuction is usually not recommended for teenagers. Liposuction should neither be used to treat obesity among teenagers, nor should it be used as a substitute for proper diet and exercise.
• Weight loss surgery is usually not recommended for teenagers. Certain severely obese young adults can be candidates for weight loss surgery. Such patients may ultimately need body contouring surgeries, including liposuction, to get rid of excess skin that can result from dramatic surgical weight loss.
• Cheek implants - is usually not recommended for teenagers since the facial features still are developing.
• Breast enhancement with saline-filled breast implants are only to be used for women who are at least 18 years old, as the breast may still be developing.
• Silicone-filled breast implants are FDA-approved for breast augmentation only for women 22 and older. For breast reconstruction is it approved for women of all ages.
• Botox and injectable fillers are approved only for people at least 18 years old.

Common Cosmetic Procedures for Young Adults

When teens look in the mirror, they focus on their most obvious features, often the nose and ears. Young girls become fixated on the size and symmetry of their breasts. Both genders struggle with the stigma of acne and the possibility of permanent scarring.

In the 13-19 age category, the most common cosmetic surgical procedure is breast reduction for males, accounting for 13,530 operations performed in 2010.

The next most popular surgeries in descending order were:

• Ear surgery or otoplasty, 29%

- Usually this procedure addresses protruding ears, which can be pinned back any time after the age of 5.

• Nose reshaping or rhinoplasty, 14%

- Commonly this procedure is used to even out the shape of the nose by straightening the bridge or contouring the overall appearance to remove lumps or bulges. At the same time, the tip may be altered to improve breathing. Generally a "nose job" cannot be performed on girls until after age 15 to 16, and later on boys.

• Chin augmentation, 9%

- This procedure is often conducted in tandem with dental work intended to correct issues with the bite pattern and the overall formation of the mouth. Normally a small implant enhances the shape of the chin, which in turn lengthens the jaw line and improves the profile.

• Dermabrasion / microdermabrasion for scar removal, 4%

- Essentially this is a procedure to smooth or refinish the skin with a fine sanding technique. Laser tools and chemical peels are also employed for this purpose.

• Breast augmentation, 3%

- According to current FDA guidelines, breast augmentation with saline-filled implants can be performed on women age 18 years or older. In teens, this surgery is normally used to correct breast asymmetry, when one breast is as much as a full cup size smaller than the other.

• Liposuction, 2%

- Although arguably one of the more questionable cosmetic procedures for teens, the increase in liposuction in this age group reflects the national problem of obesity in the younger generation. When a teen has been severely overweight and loses a significant amount of weight, both surgical skin removal and liposuction may be necessary to achieve a normal appearance.

The most popular minimally-invasive cosmetic procedures, in 2001, were laser treatment for leg veins, laser hair removal, laser skin resurfacing, microdermabrasion, sclerotherapy, and the use of fat tissue fillers (generally to augment facial features like the lips or cheeks).

Protect Your Teen from False Expectations

Every year there are millions of people who have cosmetic surgical procedures without incident. The vast majority of those are adults, however. Beyond ensuring that you are dealing with a board certified and accredited medical professional who will thoroughly evaluate your child and give you an accurate recommendation, be prepared to address the real and tender emotions that underlie your teen's desire for the procedure.

Nothing hurts more than dashed expectations, not even the pain of a surgery. While cosmetic procedures can make astonishing changes, your child may well be envisioning alterations that are not realistic. Err on the side of over-preparation, seeking multiple consultations and insisting on seeing real-life "before and after" photos that validate the surgeon's skill.

Its equally important to address the specific risks of the procedure along with all of the standard pre- and post-op concerns. The teen must also know what they can reasonably expect as far as results and how different plastic surgery will make their anatomical parts look and feel.

It may seem like an obvious aspect of plastic surgery, but it's surprising how many people still fail to fully consider that their body will be altered permanently by a plastic surgery procedure.

Adhere to the Letter of Informed Consent

Informed consent is the cornerstone of any physician-patient relationship. This is the heart of the decision-making process in which your teen should be fully involved and guided by both you as the parent and your doctor as the medical professional. Points that must be included in the discussions are:

• the specific details of the surgery
• the realistic benefits to be derived
• the possible negative consequences
• any potential adverse reactions
• the length of the recovery process
• and viable alternatives to the work being considered.

Summary:

There are clearly good and bad reasons for a teen to be allowed to undergo plastic surgery. It's actually quite difficult for anyone to say what is "right" or "wrong" when every case is different. The question of self-esteem and quality of life is central to the final decisions, and that determination is something only the parents, the teenager, and the doctor working in concert can properly evaluate. It is, however, a good touchstone to remember that if the surgery will enhance the teen's life, it is worth serious consideration.

If the teen's reasons are frivolous, however, and represent nothing more than a desire to "do what everyone else is doing," you have a different kind of problem on your hands. All parents should try to remember the complications of these highly emotional, formative years and not just dismiss a request for plastic surgery out of hand. That will only make your teen feel more diminished, which is not what you want. There are many good online resources and forums for both parents and teens to fully explore the issue of cosmetic surgery and to arrive at some degree of consensus.

Be smart. Do your homework. Look at all the relevant factors of cost, risk, reward, and recovery. This is not a subject about which to be indulgent, but as a parent, you are the person best positioned to evaluate the real reasons behind your teen's request to have a plastic surgery procedure and to respond appropriately to that request.

Read More - Additional Useful Information

Additional useful information to assist you and your teen in making the decision for or against a cosmetic procedure can be found on the following pages:

• Plastic & Cosmetic Surgery Organizations & Associations Explained
• Guide to Financing Plastic and Cosmetic Surgery
• National Average Plastic Surgery Cost per Procedure 2010
• 20 Critical Questions to Find the Right Plastic Surgeon
• Teen Breast Enlargement

Sources:

• The American Society of Plastic Surgeons. Briefing Papers: Plastic Surgery For Teenagers
• The American Society for Aesthetic Plastic Surgery, Cosmetic Surgery National Data Bank Statistics, 2007, 2008, 2009, 2010
• plasticsurgery.org/news-and-resources/briefing-papers/plastic-surgery-for-teenagers.html, Plastic Surgery for Teenagers Briefing Paper
• plasticsurgery.org/Documents/medical-professionals/health-policy/key-issues/Policy-Statement-on-Breast-Augmentation-in-Teenagers.pdf Breast Augmentation in Teenagers
• plasticsurgery.org/Articles-and-Galleries/Video-Gallery/Teen-Rhinoplasty.html Teen Rhinoplasty
• ourbodiesourselves.org/book/companion.asp?id=1&compID=102
• ncbi.nlm.nih.gov/pubmed/15625989 Elective Plastic Surgical Procedures in Adolescenc, by M.H. McGrath and W.G. Schooler, with the Division of Plastic Surgery, Department of Surgery, University of California at San Francisco
• ncbi.nlm.nih.gov/pubmed/10989327 Plastic Surgery and the Teenage Patient, by M.H. McGrath and S. Mukerji, both with the Division of Plastic Surgery and Reconstructive Surgery at The George Washington University Medical Center in Washington, D.C.
• kidshealth.org/teen/your_body/beautiful/plastic_surgery.html
• fda.gov/
• drphil.com/shows/page/TeenTalkCosmeticSurgery/
• realself.com/forum/teenage-body-image
• health.qld.gov.au/publications/cos_surg_child.pdf
• girlshealth.gov/body/grooming/cosmetic_surgery.cfm, GirlsHealth.gov
• education.com/magazine/article/When_Your_Teen_Wants_Plastic/
• drfpalmer.com/teenagers_and_plastic_surgery.html
• The Dr. Phil Show, plasticsurgery.org/Articles-and-Galleries/Video-Gallery/Teen-Breast-Augmentation.html, Teen Who Wants Breast Augmentation
• medicinenet.com/script/main/art.asp?articlekey=51431
• parentdish.com/2011/01/27/teen-plastic-surgery/
• parentingteens.about.com/od/PlasticSurgery-Teens-Statistic/Plastic-Surgery-And-Teens-Statistics-And-Advice.htm

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