Teens and Cosmetic Surgery

Many teens attempt to improve their appearance (and acceptance) by using make-up and wearing the “right” clothes. A small number of teens seek change through cosmetic surgery. According to the American Society for Aesthetic Plastic Surgery, more than 36,800 cosmetic surgery procedures were performed on Americans 18 and under last year.

Rhinoplasty, or nose reshaping, is the most common cosmetic surgery for teens, accounting for 17,040 procedures in 2009. It may be done to straighten a crooked nose, remove a bump, reshape the tip or decrease the size of an overly large nose. Sometimes the surgery is done to fix a nose misshapen by trauma (which can cause breathing problems).

Otoplasty (ear reshaping) is the second most common cosmetic surgery among teens. In 2009, nearly 9,660 of these procedures were performed in the U.S. The procedure may be done to pin back protruding ears, change the size of the ears or fix misshaped ears.

Some other cosmetic surgery procedures that may be done for teens include: correction of breast asymmetry, breast augmentation, breast reduction, liposuction and chin augmentation (enlargement).

Readiness and Safety

During the teen years, peer acceptance is a very important goal. Teens that look a little different, or are perceived as “ugly” may be picked on or socially isolated. The desire for attractiveness isn’t just a teen trait. Society as a whole tends to value good looks. Sam Rizk, M.D., F.A.C.S., Facial Plastic Surgeon in New York City, says attractive people tend to do better in school and get better jobs than equally skilled people who are less attractive.

Teens who seek cosmetic surgery are usually looking to improve on a perceived “flaw” in their appearance. However, cosmetic surgery isn’t for all teens who want it. Rizk says teens need to have realistic expectations of what to expect after cosmetic surgery. He uses a computer to create an image of the reconstruction so the teen understands the visual results of the surgery. Family support is also important.

Rizk prefers to wait to perform cosmetic procedures until a teen has physically matured, generally around 14 for girls and 15 for boys. Teens also need to understand that cosmetic surgery will not fix social problems or necessarily make a person more acceptable to peers. Consultation with a psychologist can ensure the teen is emotionally stable and mentally ready to face a life-changing surgery.

Teens and parents also need to understand that, even with an experienced surgeon, things can go wrong during surgery. Patients can develop unexpected complications, like infection, scarring or, rarely, death. Cosmetic procedures are usually not covered by insurance, so clients will need to pay out-of-pocket for the expenses.

The Technique

Though teens are nearly the size of adults, cosmetic surgery is somewhat different. Rizk uses a 3D endoscope, some different surgical instruments and more conservative techniques for teens versus adults. For rhinoplasty, he typically takes out a little less cartilage in the septum to allow for continued growth and maturity.

The 3D endoscopic technique causes less bruising, bleeding and pain, speeding recovery. Compared to adults, teens tend to heal faster. Rizk says teens generally need at least one week off from school, so many of his clients schedule surgery at the start of a school break or during summer vacation. Teens that have rhinoplasty must be very careful not to injure the nose for some time after the surgery. Thus, they can not play contact sports for at least six weeks.

For general information on plastic and cosmetic surgery for teens:

American Society for Aesthetic Plastic Surgery
American Society of Plastic Surgeons