Reconstructing A Teenager’s Life— Physically and Emotionally
Questions to ask when considering cosmetic surgery.
by Roy Geronemus, M.D.

PARENTGUIDE News March 2006

While comedians may joke that among new cars and designer clothes, nose reshaping and liposuction are now on a teenager’s wish list, in reality, cosmetic procedures can help correct physical deformities and may be a necessity for certain teenagers. On the other hand, used inappropriately by teens seeking to “perfect” themselves, cosmetic surgery can be harmful in the long run.

Teenagers and their parents must realize that there is a clear discrepancy between reconstructive and elective surgery. While both alter one’s appearance, reconstructive surgery is performed to correct a physical abnormality. Some of the conditions that warrant reconstructive surgery for a teenager may include: physical birth defects, traumatic injuries resulting from an accident or scars from severe burns. These conditions often make teenagers struggle excessively with self-esteem issues and choose not to participate in normal activities. Reconstructive surgery, when performed by a responsible physician, can help to change a teen’s life and provide him or her with enough confidence to interact with peers.

On the flip side, there has been a recent trend emerging largely as a result from programs like MTV’s I Want a Famous Face, where many teenagers seek elective surgery strictly to enhance their physical appearance. Most physicians will not perform elective cosmetic procedures on patients until they reach age 18, and even then physicians take several precautions. Unfortunately, there are some physicians who don’t take all precautions and do perform these surgeries prematurely. Even scarier is the fact that some of these “physicians” are not trained in cosmetic surgeries or may not have all the appropriate medical credentials.

Additionally, an increasing number of non-physicians are offering elective procedures such as laser hair removal or Botox injections at places like spas, salons and malls. While these locations attract a large clientele because the cost is less expensive than going to a physician, practitioners at salons and malls are often not educated to properly administer such procedures. If a customer is injured, many of these facilities do not have a doctor on site to immediately care for the injury— which can lead to permanent scarring, infections and even death. Most importantly, teens and their parents must remain aware that while some physicians/facilities will agree to perform cosmetic procedures, there may be long-term physical and emotional effects for the patient.

Before making any decisions regarding cosmetic procedures, teenagers and their parents should take the time to ask themselves the following questions:

Is my body fully developed and ready for a cosmetic procedure?
Because our bodies continue to grow and develop into our 20s, teenagers are still developing physically. Therefore, many cosmetic procedures are not entirely safe for persons under the age of 18. For example, many teens are seeking Botox injections for frown lines, which would not be appropriate or even truly effective for teens since their facial structure is still in the process of changing.

Invasive procedures, such as liposuction to reshape problem areas that may include thighs and hips, are also safest and provide the best results on patients over the age of 18, as is the case with breast augmentation. Doctors discourage teenagers from undergoing breast augmentation because the average girl’s weight fluctuates considerably between ages 18 and 21.

Are my emotions or social pressures impacting my decision?
Emotions can play a role in some teens’ desire for cosmetic surgery. It’s not uncommon for teens to believe that by enhancing their appearance, they may become more popular among their peers or get someone to notice them. Yet, social urges aren’t reason enough to undergo a serious surgical procedure.

Remember: While teens may be self-conscious about their bodies now, they are still developing. Even the sexiest Hollywood celebrity was once gawky and felt unattractive, and probably still sees numerous imperfections in their physical appearance.

Is this cosmetic procedure stuff as simple as it looks or are there risks?
All procedures have associated risks. It’s important that teenagers understand the entire process including potential side effects from anesthesia and length of recuperation time. While these surgeries are accompanied by minor side effects such as redness, swelling and some pain, other more severe side effects such as infection, repeat surgery and permanent scarring can result. No matter what the media shows, few procedures will allow you to be up and running in a day.

A salon in the mall is advertising cheap cosmetic procedures. Does that mean the procedures are safe?
If a salon’s price seems too good to be true, then it is. Consumers should be aware of the latest trend of non-physicians performing cosmetic procedures in salons, spas, clinics and malls. These “physicians” are often unqualified, and many patients are being left with undesirable results and serious health conditions. Any skin surgery or procedure should be performed by a qualified dermasurgeon. To locate a dermasurgeon near you, please visit the Web site of the American Society for Dermatologic Surgery: www.asds.net.

What procedures are right for teenagers?
There are several procedures that are safe and appropriate for teenagers, such as to treat acne, the number one skin condition among teens. With new technological advancements, doctors can now combat a variety of acne problems. Such new treatments leave skin smooth, soft and scar-free. Laser technology is also used to clear pigment deformities from serious birth defects, which typically worsen as a teenager gets older.

Since cosmetic surgery may often be life changing for many patients, undergoing a cosmetic procedure is not a decision that should be made quickly or spontaneously. Teenagers and their parents should understand and thoroughly consider all the risks.

Roy Geronemus, M.D., past president of the American Society for Dermatologic Surgery, is a clinical professor of dermatology at New York University Medical Center. He is also the director of The Laser & Skin Surgery Center of New York.