As plastic surgery patients get younger, the number of teens seeking plastic surgery is increasing. When should the answer be “yes” to teens and plastic surgery? The answer might not be so simple.

Non-invasive Procedures

Dermal fillers have also made a significant impact in how faces and lips are augmented, not only in teens, but in adults. Teens have seen their “Hollywood” role models get overdone lips and cheeks and have followed suit. Unfortunately, many of these teens have been misguided by the social media about these” teen role models.”

Most real board certified plastic surgeons recommend against the use of cosmetic dermal facial fillers and Botox during tremendous physical and psychological growth occurring in these the teen years. The rationale that fillers and Botox can have a positive effect to be used as a form of “prejuvenation” to prevent aging is significantly misguided and has absolutely no scientific basis.

Plastic Surgery

Plastic surgery Procedures for teens need to be put into the proper ethnic and medical perspective during these critical developmental years of psychological , social and developmental growth. Plastic surgeons are physicians first and foremost and must “do no harm.”

Breast enhancements are popular should not be done under age 18 due to Food & Drug Administration (FDA) recommended restrictions on the use of saline over silicone implants in this age group unless they have a significant congenital breast deformity or asymmetry after completing their final growth spurt at age 18 or later.

But teens not infrequently are seeking breast reductions do to peer ridicule ,bullying at school and back pain due to the enlarged breasts . This is a reasonable request and has significant psychological and physical advantages when done in these teenagers however the trade off for smaller breasts is a scar around the breast itself so this must be dealt with in detail with the parents and the patient by the plastic surgeon.

In boys, male breast reduction procedures for gynecomastia are in rising in demand. Gynecomastia, or the growth of male breast tissue, is considered to be the “silent male disease” and may be caused by medication side effects or obesity but may occur for other reasons. As boys fully mature and slim down, the breasts may decease in size however in severe cases may benefit from surgical attention to decrease the emotional impact of excessive breast tissue in the teen male. In some cases, this can be done via minimally invasive techniques using Ultrasonic Liposuction

Otoplasty, is a procedure that is commonly performed to reshape and correct prominent ears. It can be done during the teen years but may be done as early as age 6 or 7 when the ears are nearly adult-size, particularly if a child is being ridiculed at school with names like “dumbo ears.” The nose is also a common subject of teasing and bullying in school aged children and teens.

Surgical nose reshaping or rhinoplasty or nose reshaping is also commonly performed for both functional and psychological reasons and can often result in a dramatic improvement for teens, both physically and psychologically especially in teen girls .

10 Guiding Factors

Upticks in plastic surgery rates may have been driven by celebrity trends and the pressure of “social media” and the need to conform . The “selfie” has also been credited with increasing plastic surgery rates but the trend may be slowing. Increasing numbers of celebrities who had “botched” procedures or who simply went too far may be reducing some of the outrageous demands from teens today.

Plastic surgeons who are faced with teens wanting plastic surgery must act as guides and help both teens and parents come to a reasonable expectation. Doctors must have a frank discussion with the teen to ensure that they are mature enough to understand both the risks and benefits of a potential change, particularly if it is a permanent, surgical procedure. In some cases, teens are encouraged to “wait and see” because additional maturity may give the teen what they want over time.

Most importantly, the parents or guardians of the teens must be involved. This helps prevent mistakes and misunderstandings and helps ensure both the physical and emotional safety of the teen.

The 10 guidelines for Ethical Plastic Surgery in Teens

1. Engage the teen in a frank discussion about their concerns and desires with parental or guardian involvement before considering any type of elective Plastic Surgery.

2. The use of treatments to improve skin appearance from acne scarring or dermatologic problems may include chemical peels and or laser therapy.

3. The use of Botox and cosmetic fillers for facial enhancements are generally and broadly discouraged unless there is a medical reason for this type of treatment including a facial nerve palsy or acquired or congenital lip or cheek deformity.

4. Breast augmentation is not done electively under age 18 and only saline implants are used to age 22 and must be done with proper counselling.

5. Breast Reduction or reshaping and the use of breast implants for correction of significant congenital deformities or significant asymmetries is reasonable with proper patient counselling.

6. Male Gynecomastia (male breast enlargement) can be treated if it does not subside in the later teen years with proper counselling.

7. Otoplasty (correction of prominent ears) can and should be done at an early age if possible from age 5-7 as the ears are almost fully grown . This is also before the intense peer to peer bullying behavior starts with this deformity.

8. Rhinoplasty is indicated for correction of functional or traumatic deformities as well as significant cosmetic deformities due to peer ridicule (especially in girls ) at age 15-17 in females vs 17-19 in males due to the growth spurt lag in males.

9. Liposuction or body contouring procedures are not indicated in most teens as this can be properly treated with diet. exercise and nutritional counseling in most cases.

10. The key and most important element to optimal outcomes, proper decision making and safety is to find an emphatic, board-certified real plastic surgeon who is certified by the American Board of Plastic Surgery. The plastic surgeon must have the proper expertise, judgement and experience in the management of the complex issues in dealing with the mindset of the developing teenager.

Can’t get enough of Dr. Rod Rohrich? Find out why even surgeons need role models.