The Teenage Plastic Surgery Boom

Here's a disturbing trend: Between 1996 and 2010 the number of teenagers aged 13-19 having elective cosmetic surgery has increased by 548% - from around 14,000 procedures to 76,841 last year, according to American Society of Plastic Surgeons (ASPS). The vast majority of these surgeries are rhinoplasty, followed by octoplasty (ear-pinning, typically), breast augmentation, asymmetry correction and reduction, and liposuction.

Why would so many kids go under the knife? Almost without exception, the surgeries are performed in response to teasing, bullying and low self-esteem. The ASPS says that teens "tend to have plastic surgery to fit in with peers, to look similar," by "improv[ing] physical characteristics they feel are awkward or flawed, that if left uncorrected, may affect them well into adulthood." Thirteen-year-old Nicolette Taylor (shown above) had a nose job after kids at school teased her; the "Hey, big nose," comments followed her to Facebook before her parents stepped in and opted to have Nicolette's nose reconstructed. She's not alone, either -- ABC reports that at least 90,000 such surgeries were performed last year “to avoid being bullied.”

Of course, a teenager can't just walk into a doctor's office and request a consult. Richard D'Amico, president of the ASPS, speaking with U.S. News and World Report, says that for anyone under age 18, a parent or guardian must be present and the prospective patient must have the maturity to understand the procedure, be able to express that "the desire for surgery does not reflect what a parent, friend, or boyfriend desires" and have realistic expectations. Even so, it becomes obvious when looking at the numbers that often surgery is a knee-jerk response to what most adults would consider the norms of teenage interaction. And it seems to skip over that "it builds character" thing that previous generations admired so strongly before plastic surgery was so widespread and available. Succinctly, Sheri Reed of The Stir asks, "[Plastic surgery], in no way, attempts to deal with the emotional matters behind a bully's behavior, nor does it teach the teen who hates herself the important life lesson of resilience."

How do parents justify plastic surgery for their children? There are no laws governing the minimum age for cosmetic procedures. Standard policy requires that a patient reaches a point of growth maturity beforehand, which is determined by monitoring changes in shoe size or height. There are two types of procedures: corrective and cosmetic. In the first camp, you have surgeries to repair deviated septa, cleft palates, under- and over-bites and any malformation or physical impairment that affects the quality of life. One teenager in the news recently will be having a series of procedures to correct her severe underbite; while kids do tease her about her protruding jaw, Samantha Weichhan's orthodontists Drs. Jerry Blum and Margo Brilliant argue that the process is not cosmetic. "It’s kind of like if you have somebody that one leg is 4 inches shorter than the other leg, and they say to straighten it out is an aesthetic thing. No, it’s not an aesthetic thing. Yeah, you will look  better if you’re standing straight on both legs, but point is, it’s a functional problem.” But those aren't the worrying procedures.

In Nicolette Taylor's case, whose nose operates just fine, getting cosmetic surgery to change the way she looks in response to some posts on a Facebook wall (which, incidentally, are not supposed to be opened by 13-year-olds according to Facebook's Terms of Service), the reasoning becomes a little hazier. Rob Taylor, Nicolette's father, explains it this way to ABC: "You send them to a good school. You’d buy them shoes. You’d get them braces, which we did. It’s that kind of thing.” The parents of Kaitlyn Clemmons, who gave their 18-year-old daughter breast augmentation surgery as a Christmas gift, see the pain of the procedure as something akin to the pain after a trip to the gym. "Everything comes with a price," her stepfather says. Tracy Carp, who had breast augmentation at 17 with her parents' consent and recently underwent a second procedure to reshape a "slight bump" on her nose, says that "a little bit of cosmetic work" has helped his daughter "feel much better about herself . . . and healthier."

What price hotness? A new nose or sleeker profile aren't free, even if the surgery is performed pro bono or paid for by insurance. The ASPS urges teenagers and their parents to remember that "plastic surgery is real surgery, with great benefits, but also carries some risks." In 2008, Pennsylvania courts awarded $20 million to a family of an 18-year-old girl who died from what was "likely a pulmonary embolism after liposuction." The same year, 18-year-old Stephanie Kuleba of Florida died of malignant hyperthermia, a rare reaction to anesthesia, after undergoing cosmetic breast surgery. “This is something that can happen in any surgery, on any part of the body, in any setting,” D’Amico said. Other risks? MRSA infection, a deadly strain of staph, which killed more US patients in 2008 than AIDS. Unskilled or shady surgeons, like the man who gave Priscilla Presley injections of "industrial, low-grade silicone" after convincing her that it was a miracle fix for wrinkles. And then there are always the kids who will tease you for having a nose job or breast implants.

Given all the factors that accompany an elective procedure, would you consent to or support plastic surgery for your own kids if they were being teased about their physical appearance?

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I read a quote once, and wish I could remember who it was that said it or what exactly they had said, but it went like this:

Just as the theory of evolution provides a wealth of explanatory power to biologists, I believe everything [psychological] can be explained by egoism. - Unknown
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Well this is so obviously about self-presentational concern (self-esteem). It hardly needs mentioning that none of this would be a problem if one's sense of worth was not contingent on domains as unstable as one's physical appearance.

Some interesting thoughts on the subject here, but most of them appear to be rather naive, and assume that self-esteem is somehow axiomatic. That one cannot be content without the positive approval of others, and that justifies changing who you are in order to attain approval or to avoid disapproval.

If I had a definition for weak-willed...
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I think it's tough for young children today to fit in and feel excepted....if a child's self-esteem will improve and make he or she feel better....I say go for it. It's at that young and impressionable age that teasing and bullying can really impact your life and how you feel about yourself in adulthood. There is nothing wrong with reasonable plastic surgery...it's when you go overboard with false expectations that may be problematic down the line.
Who doesn't want to feel better about themselves...we all do...it's a fact of this superficial life we live in.
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I doubt it's a case of "we're going to beat you up because your nose is big". I think most of the "bullying" they're referring to would be girl-on-girl bullying.

I do remember going to school with Cindy, who was intelligent, had a great personality, and big boobs. What was she remembered for? Her big boobs, of course. A year after high school, I met her in the big city, and she was thrilled to tell me she was going in for reduction, partly for her health, but mostly for her self-esteem. Sometimes, you just need to do what you gotta do. All the people saying, "but she looks fine in the first picture" are being as judgemental as bullies.

I can understand an objection so frivolous surgery, but some cases are just necessary.
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