Aesthetic plastic surgery in minors (under the age of 18), also called teenage plastic surgery, has its own unique set of challenges. Many plastic surgeons perform procedures on minors as attested to the over 75,000 operations reported by the members of the American Society of Plastic Surgeons in 2012. The most common procedures for teenagers were rhinoplasty, gynecomastia reduction, otoplasty, breast reduction and liposuction.
While there are exceptions, the vast majority of plastic surgery is teens is done to improve an awkward feature or one that makes them very self-conscious or is teased or bullied as a result of it. This creates a natural desire to fit in with their peer groups unlike in some adults who may have plastic surgery to stand out or be more attractive. This is not to say that there is not a strong desire for some teens to be more beautiful or be driven by the appearance of some celebrity, but the cost of plastic surgery makes the pursuit of such aesthetic goals unrealistic for most teenagers and unsupported by most parents as well.
Classic examples of awkward and dysfunctional teenage features would be large and uncomfortable breasts in girls and the development of unsightly breast tissue in boys. These are frequent teenage plastic surgeries because they have been historically covered by medical insurance. The same can be said for nasal breathing problems in either girls or boys who will have to pay extra to have the outer portion of their nose reshaped at the same time.
While much is made of whether a teenager is mature enough to be making a good decision about having plastic surgery, their needs or desire for it is not really much different than in any adult. They may be some family dynamics between a teenager and their parent(s), particularly when the minor is pro surgery and the parent is con, but the bigger psychological issue is one of realistic expectations. In today’s society where images and the ‘benefits’ of having plastic surgery are exaggerated by internet and media exposure, teenagers have little appreciation for what plastic surgery can and can not do and even less tolerance for the realities of recovering from it. This is where having a good rapport with the parent(s) is very critical as they become the buffer in the after surgery period.
The demand for teenagers seeking plastic surgery is only going to slowly increase. We live in an era of unprecedented internet social exposure of which Facebook is just the tip of the iceberg. Teenager’s faces and bodies have public exposure like never before which exposes them to being judged not only in their local community but from just about anyone around the world. And we all know well that much of these judgments are more likely to be negative than positive. The lack of any online accountability and the refusal of most internet sites to do any highly responsive monitoring has raised ridicule and bullying to levels never seen before.
One of the other phenomenon of internet exposure is that plastic surgery can seem ‘magical’ to teenagers. This is particularly seen in celebrity plastic surgery images where teenagers have no concept of the degree of image manipulation that goes on and that plastic surgery can not make someone look perfect or like someone else. Plastic surgery involves real risks and recovery and rarely, if ever, is any result perfect. This makes surgery for relatively minor issues, particularly on the face, a potential setup for disappointment in the unrealistic teenager who may behaving the surgery in the hope that it will have some transformative effect on their lives.
Dr. Barry Eppley