Teens and Plastic Surgery: 10 Key Points to Consider

Rod J. Rohrich, MD

Disclosures

August 17, 2017

A recent trend shows that not only are patients undergoing plastic surgery getting younger, the number of teenagers seeking plastic surgery is growing.[1,2] What kinds of procedures are common among teenagers? When should we say "yes" to teens having plastic surgery? The answer is not always so simple.

Noninvasive Procedures

Recent statistics indicate that cosmetic and plastic surgery procedures among teens are on the rise, but this trend is not necessarily alarming.[1,2] Common procedures that teens ask for include noninvasive skin procedures such as microdermabrasion, chemical peels, and laser skin resurfacing, primarily for the treatment of acne scarring. These types of procedures help to make acne scars and skin discolorations less obvious and can improve the overall appearance of the skin. They always should be performed under the care of a qualified, board-certified plastic surgeon or dermatologist.

Over the past 5 years, dermal fillers have also made a significant impact in how faces and lips are augmented in teenagers and adults. Teens have seen their Hollywood idols get overdone lips and cheeks and have followed suit. Unfortunately, many of these adolescents have been misguided by the social media about these teen "role models." A high majority of board-certified plastic surgeons are recommending against the use of cosmetic dermal facial fillers and Botox during the teenage years, when tremendous physical and psychological growth is occurring. The rationale that fillers and Botox can have a positive effect and can be used as a form of "prejuvenation" to prevent aging is significantly misguided and has absolutely no scientific basis.

Perspective on Plastic Surgery Procedures

Plastic surgery procedures for adolescents need to be put into the proper medical perspective during these critical years of psychological, social, and developmental growth.[2,3,4,5] Plastic surgeons are physicians first and foremost and must "do no harm."

Breast enhancements are popular but cannot and should not be performed on patients younger than 18 years. The US Food and Drug Administration recommends the use of saline instead of silicone implants in patients 18-22 years of age, unless the patient has a significant congenital breast deformity or asymmetry after completing their final growth spurt at age 18 or later.

Not infrequently, teens seek breast reductions because of peer ridicule, bullying at school, and back pain.[3,4,5] This is a reasonable request and has significant psychological and physical advantages; however, the tradeoff for smaller breasts is having a scar around the breast. The plastic surgeon must discuss this in detail with the parents and the patient.

Male breast reduction procedures for gynecomastia are also growing in demand for young boys. Gynecomastia, or the growth of male breast tissue, is considered the "silent male disease" and may be caused by medication side effects, obesity, or other reasons. As boys fully mature and slim down, the breasts may decrease in size without intervention; however, in severe cases, teenage boys may benefit from surgical attention to blunt the emotional impact of excessive breast tissue. In some cases, this can be done via minimally invasive techniques using ultrasonic liposuction.[6]

Otoplasty is a procedure that is commonly performed to reshape and correct prominent ears. It can be done during the teen years and even as early as age 6 or 7 years, when the ears are nearly adult-size, particularly if a child is being ridiculed at school.[7]

The nose is also a common subject of teasing and bullying in school-age children and teens. Surgical nose reshaping, or rhinoplasty, is also commonly performed and can often result in dramatic physical and psychological improvements for minors, especially teenage girls.

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