LOS ANGELES — The baseball that hit Darlene in the face changed more than her appearance. It made her the butt of classmates' jokes. More importantly, she had trouble breathing. By 16, she wanted it fixed. Tony was also 16 when he reached the same conclusion about his oversized jaw.
They are part of a small but significant trend: teenagers turning to plastic surgery to solve physical deformities, correct congenital defects, or make them look and thus feel better about themselves.
Becca is one of those teens. She asked for breast augmentation for graduation from a New York City high school. So is William, who worked summer jobs in Indianapolis to help pay for surgery to remove excessive male breast tissue.
Experts say plastic surgery can be necessary for teens in some situations, but they question many of the procedures and worry that plastic surgery won't cure underlying problems.
Trending up or down?
The plastic surgery "trend" for teens depends on who counts and when. Researchers at the American Society for Aesthetic Plastic Surgery call reported increases a media concoction. Their numbers show a slight drop from 10 years ago. But in 2005 the numbers dipped, so now comparisons to that year show an "increase." They count about 209,000 procedures for all kids 18 and under.
The American Society of Plastic Surgeons said nearly 219,000 procedures were done just on teens in 2010. They said the most common were nose reshaping, male breast reduction, fixing protruding ears, breast augmentation and liposuction. Breast augmentation is not supposed to happen for cosmetic reasons under age 18, by FDA recommendations. But it does. Teens also underwent laser skin resurfacing, chemical peels and dermabrasions, counted in some statistics and not others. Botox injections were not usually included. That's on the rise among teens.
Because teens may be too young or immature to see future ramifications, may not have stopped growing, and may have unrealistic expectations of what procedures will do for them, doctors, teens and parents must step carefully as they explore the gray areas to decide whether to proceed, according to experts.
Some cases are black-and-white, said Dr. Anthony Youn, the Tony who had his jaw reduced as a teen and is now a plastic surgeon in Detroit. Most doctors believe what's called "ear-pinning" on minors is reasonable, though "when" is debatable, since a young child may not understand the risks and may be growing.
"Most would say injecting botox into a teenager to prevent wrinkles is morally reprehensible," as is liposuction or breast augmentation for a teen, he said.
What about a teen who wants a nose job to fix a "big bump" that's causing her misery among peers? It's an easy question if it also causes breathing problems. "If it's just cosmetic, you could live a happy life, but could it improve quality of life? Gray areas like that are what people argue about," Youn said. "I wouldn't say it's immoral to do this. As a father, it's not something I would do, but for a surgeon who feels it is a moral decision, I would not argue.
"The problem with kids is they are often not mature enough to make that kind of decision on their own," said Youn, who wrote "In Stitches," a book about experiences on both sides of the knife. "Women can go their entire lives with small breasts and be happy and normal and that's not something that needs to be done. It's not the same as someone in chronic pain because breasts are extremely large."
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