Should Your Teen Have Plastic Surgery?   

What do Selena Gomez’s nose, Kylie Jenner’s lips, Justin Bieber’s chin, and Ariana Grande’s cheekbones have in common?  They are some of the most gazed-upon facial features in the world, and therefore are some of the most coveted looks, according to both Instagram – and plastic surgeons.

It shouldn’t be at all surprising that so many of our teens today consider altering their faces and bodies, when they spend hours each day looking at such perfect physical specimens on social media and wishing they themselves had more “heart taps” on every selfie they post. Did you know that according to Instagram, in 2018 a heart emoji was used in comments 14 billion times?

That’s a whole lotta faces checking out and liking other faces.

And while the universal popularity of social media platforms has undoubtedly led many teens to consider cosmetic surgeries, adolescents have forever been dissatisfied with their appearance.

What to consider if your teen wants to have plastic surgery.
Is it a good idea for our teens to have plastic surgery? (ABO PHOTOGRAPHY/Shutterstock)

I was one such teenage girl, back in the mid-1980’s who had a serious hate-hate relationship with my nose. (I hated how I couldn’t really smell very well but even more so, I hated how my nose looked.) This was years before the internet debuted, and decades before Instagram and Snapchat became teen obsessions.

Looking back, it’s interesting that I have absolutely no memories of anyone ever telling me I had a big nose or making fun of my appearance. But starting in middle school, every single time I looked in the mirror, all I could see was a nose that completely overtook my entire face. By the time I got half-way through high school, I couldn’t stand it anymore, and asked my Mom if I could pleeease get a nose job. Relief washed over me when she and my Dad agreed, only because my deviated septum could be repaired at the same time.

Because of my own teenage insecurities, the current U.S. statistics do not surprise me at all.  And if teens themselves could easily pay for cosmetic procedures, I bet that the numbers would be considerably higher.

In 2017, about 229,000 teens ages 13-19 had cosmetic procedures performed on them, ranging from minimally invasive measures like laser skin resurfacing to surgeries like breast augmentation and liposuction.  Overall, cosmetic procedures in 2017 increased by 11%, with Americans shelling out more than $6.5 billion dollars to alter their looks.

So, what would your response be if your 14-year-old daughter came to you and asked for you to pay for cheek implants? Or if your 16-year-old son begs you to have his ears surgically pinned back?

In the fall of 2018, the American Society of Plastic Surgeons (ASPA) released new guidelines for cosmetic procedures for teenagers. This is the first time ever that the organization has issued guidance on safety considerations for patients younger than 19.

The official medical guidelines state that some forms of plastic surgery are appropriate for teens:

Rhinoplasty (nose reconstruction), although it should be delayed until after ages 15-17 in girls, and ages 16-18 in boys, when the nose stops growing. According to the ASPA, the average cost for a rhinoplasty is $5,125.

Otoplasty (surgery to correct ear deformities or to diminish the appearance of large ears on younger children and teens.)  Average cost, $2,909.

Augmentation Mammoplasty or Gynecomastia (Breast reduction for young women or men with uncomfortably large breasts.) The ASPA advises doctors to carefully consider the age and physical development level of any teenager considering breast augmentation. Breast tissue development is completed at a wide range of ages (11.8 years to 18.9 years) and about 70% of patients experience re-growth after surgery, which can lead to a second procedure. Average cost for females is $8,435 and $6,863 for males.

Surgical procedures such as liposuction, unless part of a breast reduction surgery, and saline breast implants for purely cosmetic enhancement reasons, are not advised for patients under 18 years-old. (And for silicone implants, under 22 years old.)

Board-certified plastic surgeon Rod J. Rohrich, M.D., co-author of the ASPA teen guidelines, also cautions parents,

It’s concerning that there has been a surge in the use of injectables in young patients to achieve augmented cheeks and lips when there is no evidence that these procedures are safe for adolescents.

As parents, the cost of a procedure is just one aspect of deciding whether or not your teen should undergo cosmetic surgery.

Have they been subjected to ridicule or bullying behaviors due to their physical appearance, or do they merely want to look like a celebrity? Are they in daily physical discomfort or truly suffer from low self-esteem because of one body part or facial feature?

Many younger teens may not even realize that those people they follow on social media (especially celebrities) have most, if not all, of their public images filtered and photoshopped. Unrealistic expectations must be addressed as well. Does a 13 or 14-year-old girl fully understand that getting lip fillers and microdermabrasion will not suddenly make her look just like a Kardashian?

Any responsible plastic surgeon or physician who does or oversees cosmetic procedures will make sure that parents are supportive and on the same page as their child before accepting them as a patient.

There needs to be honest discussion about how surgical effects can change over time due to genetics, aging, and BMI fluctuations. Some doctors even go so far as to have an assurance from the family that the teen will help pay for part of their surgery, and not just have their parents accept full financial responsibility.

I imagine if Snapchat selfies had been a thing back when I was in high school, I would have probably started asking about altering the size and shape of my nose at age 14, rather than waiting until I was almost 17. Or maybe I would have found a body-positive site or two that made me feel much more comfortable with my prominent nose.

I laugh now that back in the summer of 1984 when I first saw a large group of friends about a month after my nose job, only one person commented to me that my face looked “a little different.” I guess I had been expecting everyone to notice a significant change because I felt so much more self-confident. Perhaps my closer friends were just being polite by not saying anything to me, but I realized that my Mom’s wisdom was and is still true to this day. Nobody notices the details of your appearance as much as you do.

The author wishes to remain anonymous.


20 Things I’d Tell My High School Self

Body Image: What Happens When My Daughter Looks in the Mirror

About Grown and Flown

Mary Dell Harrington and Lisa (Endlich) Heffernan are the co-founders of Grown and Flown the #1 site for parents of teens, college students and young adults, reaching millions of parents every month. They are writers (Lisa is a New York Times bestselling author), moms, wives and friends. They started the Grown and Flown Parents Facebook Group and are co-authors of Grown and Flown: How to Support Your Teen, Stay Close as a Family, and Raise Independent Adults (Flatiron Books) now in paperback.

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