Nose reshaping (rhinoplasty), the most frequently performed surgical procedure among teenagers

Statistics gathered over the last several years indicate a rise in the overall number of cosmetic (aesthetic) surgeries; however, the percentage of teenagers (those 18 and younger) having cosmetic surgery has remained relatively constant, with nonsurgical procedures including chemical peel, laser hair removal and microdermabrasion being the most popular in 2003, according to the American Society for Aesthetic Plastic Surgery (ASAPS) .

The most frequently performed surgical procedure for this age group in 2003 was nose reshaping (rhinoplasty). Most experts agree that for appropriately selected teenage patients, cosmetic plastic surgery can have a positive impact on physical and emotional development.

Evaluating Teenagers for Cosmetic Plastic Surgery

As the premier society of American Board of Plastic Surgery certified surgeons specializing in cosmetic surgery, the American Society for Aesthetic Plastic Surgery offers these guidelines for evaluating teenagers who are considering cosmetic plastic surgery:

•  Assess physical maturity: Operating on a feature that has not yet fully developed could interfere with its growth, and continued growth could negate the benefits of surgery in later years.
• Explore emotional maturity and expectations : As with any patient, the young person should appreciate the benefits and limitations of the proposed surgery, and have realistic expectations.
• Check credentials : State laws permit any licensed physician to be called a “plastic” or “cosmetic” surgeon, even if not trained as a surgeon. Look for certification by the American Board of Plastic Surgery . If the doctor operates in an ambulatory or office-based facility, the facility should be accredited . Additionally, the surgeon should have operating privileges in an accredited hospital for the same procedure being considered.
• Explore risks and expected recovery times . Teens and their parents should understand the risks of surgery, postoperative restrictions on activity, and typical recovery times.

Common Cosmetic Plastic Surgical Procedures for Teens

The following are among the most common surgical procedures performed on those 18 years of age and younger, according to ASAPS statistics:

• Rhinoplasty : Nose reshaping is the most requested aesthetic surgical procedure by teens. It can be performed when the nose has completed 90 percent of its growth, which can occur as early as age 13 or 14 in girls and 15 or 16 in boys.
• Breast reduction : Breast reduction is frequently performed on girls with overly large breasts that may cause back and shoulder pain, as well as restrict physical activity. Breast reduction usually is delayed until the breasts have reached full development.
• Correction of breast asymmetry : Surgery can be performed when one breast significantly differs from the other either in size or shape. Except in cases of asymmetry and post trauma reconstruction, federal regulations prohibit breast implants for those under 18.
• Treatment of Gynecomastia : In some teenage boys, excessive breast development (gynecomastia) can become a significant psychosocial problem. Excess tissue can be removed to achieve a more masculine body contour.
• Chin augmentation : Chin augmentation often is performed in conjunction with rhinoplasty to achieve facial balance.
• Lipoplasty (liposuction) : Lipoplasty may be appropriate for a select number of teenagers of normal weight with localized fat deposits when diet and exercise fail to achieve results. Stubborn fat deposits can be a hereditary condition.

Trends in Teen Cosmetic Surgery

“Trend” reports in the media of a significant increase in teen cosmetic surgery are not supported by authoritative statistics compiled by ASAPS:

For those 18 and under:

• There were 59,890 procedures in 1997 representing 2.9% of the total;
• there were 87,147 procedures in 1998 representing 1.3% of the total;
• there were 175,189 procedures in 1999 representing 3.8% of the total;
• there were 145,094 procedures in 2000 representing 2.5% of the total;
• there were 298,707 procedures in 2001 representing 3.5% of the total;
• there were 220,077 procedures in 2002 representing 3.2% of the total;
• and there were 223,594 procedures in 2003 representing 2.7% of the total.

The number of lipoplasty procedures performed on those 18 and younger has remained low, reflecting careful patient selection among this group: ASAPS statistics show that the number of procedures has increased from 2,504 in 1997 to 3,757 in 2003.

Surveys of public confidence in cosmetic plastic surgery have consistently shown growing acceptance of elective procedures, yet data so far conclude that those 18 and under are not seeking these procedures in disproportionately rising numbers. In fact, a 2004 consumer survey sponsored by ASAPS showed that 18-24 year olds (the youngest age group surveyed) are the least likely of any group to consider cosmetic surgery. Only 17% said they would consider cosmetic surgery, compared to 31% of Baby Boomers age 45-54.