Plastic surgery in teens has again come to the forefront, this time due largely to a recent report by the NBC "Today Show" and USA Today. Probably the most significant issue is a report by the American Society of Plastic Surgeons (ASPS) that described a 180% increase in plastic surgery in teenagers from 2003 to 2008.
The core issue is: when is it appropriate for a teen to have plastic surgery? It has long been standard practice for plastic surgeons to agree to perform plastic surgery on teens with an abnormally enlarged nose (Rhinoplasty) or prominent and protruding ears (Otoplasty). The goal was to help these kids not stand out and to move beyond being an object of ridicule, and by and large these goals were accomplished.
More controversial is performing liposuction and breast augmentation in teenagers. Are we helping their self esteem or are we starting them on a path of a preoccupation with their appearance in which the solution is always plastic surgery.
There is no clear answer. However, most would agree that the average teenager can take care of small areas of unwanted fat with a sensible diet and exercise. Liposuction was never meant to be a weight loss tool or treatment of obesity. So it would seem that the indications may sometimes be very reasonable but would be few and far between.
Breast augmentation is more complex because it involves placement of a permanent implant. Teenagers are not adults and should not be expected to fully understand all of the implications of having an implant. Although the overwhelming majority of women who have had breast augmentation are happy that they did, they are making this decision with an adult thought process. As a result, the American Society of Plastic Surgeons (ASPS) and the FDA have restricted the use of saline breast implants to women at least 18 years of age and silicone gel implants to women at least 22 years old. Exceptions are made for birth deformities and severe asymmetry.
This topic raises more question than answers, but it seems that it would be fair to say that plastic surgeons, patients and families should proceed very cautiously when considering plastic surgery on a teenager.