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The overwhelming influence and ubiquitous presence of social media in the lives of teenagers along with their near addiction to taking of selfies have too often created a crisis of appearance in their minds. Due to their age and fragility of ego during this vulnerable period of time, they already are quite sensitive about their looks. Unfortunately, the present digital age has created preoccupations and obsessions about their physical traits that are not truly healthy. It also has made it exceedingly easy for them to become victims of cyber bullying which can lead to suicide.

Research published in the September 2018 issue of Plastic and Reconstructive Surgery® by board certified plastic surgeons Rod J. Rohrich, M.D. and Min-Jeong Cho, M.D. determined that around 229,000 cosmetic procedures were performed on patients aged 13 to 19 in 2017. This constitutes 4% of all cosmetic procedures performed that year. These range from a rhinoplasty, otoplasty (ear pinning) and breast reduction (male and female) to breast augmentation and even liposuction.

Teenagers also underwent a wide variety of non-surgical cosmetic procedures though they constituted only a small percentage of the total amount of these procedures performed. Among these included a wide variety of dermal fillers, Botox®, laser skin resurfacing, laser hair removal, microdermabrasion and chemical peels.

Many of these surgical and non-surgical procedures can be appropriate in the right situation for the right individual who is also mature and well informed. However, others like Botox®, fillers for lip enlargement and facial sculpting, breast augmentation and liposuction in minors should generally be discouraged most of the time. There are a multitude of reasons for this opinion though I won’t go into details here. Consequently, my general policy is not to perform elective, cosmetic breast augmentations or liposuction in anyone who is not at least 18 years of age. The same goes for Botox® and any fillers such as Juvederm® as well as certain other non-operative procedures.

So what procedures might be appropriate and justified in the right individual especially in the under 18 sub-group? The following are a few of the more popular of these procedures and thoughts on them:

Breast reduction –
Markedly enlarged breasts in girls that are strongly associated with neck, back and shoulder pains and often leading to limitation of certain physical activities is a great indication for this procedure. So are emotional issues, embarrassment and even bullying related to their quite large size. Though ideally it is preferable to wait until the breasts stop growing, there are many situations where just proceeding with surgery is a no brainer. This can include girls even as young as 14 as I have done on several occasions.

Boys who experience substantial gynecomastia that does not resolve in a particular period of time can strongly benefit from a male breast reduction. So can those boys with hormonal and/or weight issues leading to “C”, “D” or even larger cup size breasts which are devastating to them on many levels. There is rarely a reason to wait until they are much older before proceeding with male breast reduction surgery.

Ear Pinning (Otoplasty) –
Prominent, over projecting ears quite often leads to incessant teasing, embarrassment and other issues. Many teenage girls with protruding ears refuse to wear their hair up because this would expose their embarrassing ears. Surgical treatment by “pinning” them back is a well-accepted, successful, long standing and commonly performed procedure. The general recommendation is to wait until an individual is at least 5 years of age before proceeding. It is frequently performed on both teenage boys and girls.

Rhinoplasty –
This is a very commonly sought out procedure by both boys and girls and understandably so. After all, a significant deformity right there in the middle of the face of an already emotionally fragile teenage can be horrifying to say the least. The general consensus is to wait until the nose stops growing which is around the age of 15 to 16 in girls and 16 to 18 in males. Recommendations for surgery and its timing should be individualized.

For teens contemplating cosmetic plastic surgery, it is highly recommended that they consult with one or more reputable board certified plastic surgeons. Those who are younger than 18 years of age must also be accompanied by a parent or legal guardian and have parental/legal consent if surgery is to be pursued.

If you have any questions about the above, regarding a plastic surgery procedure or to schedule a consultation, please contact my office.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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