Treating teens: Self-esteem, expectations determine cosmetic procedures

Key Points

National report-In the late 1990s and early 2000s, a good deal of media attention focused on the rising number of cosmetic surgery procedures performed on teenagers.

According to the American Society of Plastic Surgeons (ASPS), the total number of cosmetic procedures performed on individuals ages 13 to 19 was 244,144 in 2006, the most recent year for which age-distribution statistics are available. The total represents a scant 1 percent rise over the number of procedures performed in 2005.

In the latter category, the total number of procedures performed on teens was 150,158 - a 5 percent increase over the 2005 total.

Surgical procedures totaled 93,966-a 6 percent decrease from the previous year's number.

Stabilization in the number of teen procedures may well be due to physicians increased awareness of - and sensitivity to - the pros and cons of these procedures for young people.

Joel Schlessinger, M.D., director of Skin Specialists P.C., Omaha, Neb., and immediate past president of the American Society of Cosmetic Dermatology&Aesthetic Surgery, says there is a fine line between appropriate and inappropriate cosmetic surgery in teens.

"I frequently see parents who desperately want liposuction or facial surgery for their teens, sometimes before their final body shape and outcome is determined," Dr. Schlessinger tells Dermatology Times.

"While I often remove nevi from pre-teens and teens, for example, facial surgery is a different issue altogether."

'Additionally, body image and the level of maturity to understand the ramifications of liposuction and its complications are something that few teens are prepared to consider.'

"Because of this, I don't perform such surgeries on teens," he says.

Other physicians seem to be following suit.

According to ASPS statistics, liposuction procedures among the teen population in 2006 were down 4 percent from 2005 totals.

"I see the pros of cosmetic procedures on teens as being when the procedure can increase self-esteem," says Mitchel P. Goldman, M.D., medical director of La Jolla Spa MD in La Jolla, Calif.

"For example, if a teenager has a familial problem, like big hips or no breasts, cosmetic procedures are very appropriate. Another example is the minimization of acne scars with laser resurfacing."

"On the other hand, to do breast implants when the breasts are normal to begin with is one of the cons of cosmetic procedures on teens," Dr. Goldman says.

"Another is to do liposuction just as a weight-loss fix where exercise and diet are more important, and more appropriate," he says.

Dr. Schlessinger agrees.

"When I hear stories about teens who have undergone large-volume liposuction, it truly makes me sad, both for the parents and the teens," he says.

"As a parent, I would do anything in my power to help my child, but such procedures just aren't appropriate at this age. One case in Texas was touted by a plastic surgeon who appeared on many television shows - only to have a postscript noting that the child gained all the weight back."

"Not only did this pose a significant risk of morbidity and mortality for the teenager, but it wasn't warranted, and certainly didn't prove successful," Dr. Schlessinger says.