Briefing Paper: Plastic Surgery for Teenagers
Teenagers who want to have plastic surgery usually have different motivations and goals than adults. They often have plastic surgery to improve physical characteristics they feel are awkward or flawed, which, if left uncorrected, may affect them well into adulthood. Teens tend to have plastic surgery to fit in with peers. Adults tend to have plastic surgery to stand out from others.
Plastic Surgery Statistics: Cosmetic Patients Aged 19 and Under
Common physical characteristics or concerns a teen may wish to correct include a misshapen nose, protruding ears, overly large breasts, asymmetrical breasts or severe acne and scarring.
Teens frequently gain self-esteem and confidence when their physical problems are corrected. In fact, successful plastic surgery may reverse the social withdrawal that so often accompanies teens who feel different. According to ASPS statistics, 23,527 cosmetic surgery procedures were performed on people aged 19 and under in 2022, while 244,252 minimally invasive cosmetic procedures were also performed.
Not every teenager seeking plastic surgery is well suited for an operation. Teens must demonstrate emotional maturity and an understanding of the limitations of plastic surgery. ASPS cautions teenagers and parents to keep in mind that plastic surgery is real surgery with great benefits, but it also carries some risks. Teens should have realistic expectations about plastic surgery and what it can do for them. In addition, certain milestones in growth and physical maturity must be achieved before undergoing plastic surgery.
Although health insurance does not pay for cosmetic plastic surgery, coverage is often provided when a procedure alleviates physical symptoms or improves a body function. Such is usually the case, for instance, when breast reduction eliminates severe back and neck pain. It should be noted, however, that health insurance coverage varies greatly between healthcare plans.
Statement
As with any surgery, parental consent is required for all plastic surgery procedures performed on teens younger than 18 years old. The ASPS advises parents to evaluate the teenager's physical and emotional maturity and believes that individual cases merit careful evaluation under the guidance of a plastic surgeon certified by the American Board of Plastic Surgery. The most rewarding outcomes are expected when the following exist:
The teenager initiates the request. While parental support is essential, the teenager's own desire for plastic surgery must be clearly expressed and repeated over a period of time.
The teenager has realistic goals. The young person must appreciate both the benefits and limitations of plastic surgery, avoiding unrealistic expectations about life changes that will occur as a result of the procedure.
The teenager has sufficient maturity. Teenagers must be able to tolerate the discomfort and temporary disfigurement of a surgical procedure. Plastic surgery is not recommended for teens who are prone to mood swings or erratic behavior, who are abusing drugs and/or alcohol or who are being treated for clinical depression or other mental illness.
Common Plastic Surgery Procedures for Teens
Rhinoplasty
Plastic surgery may be performed on the nose to straighten the bridge, remove an unsightly hump, reshape the tip or open breathing passages. Ordinarily, this is not performed until the nose reaches its adult size – about age 15 or 16 in girls and a year later in boys. In the event of a prior injury or obstruction to breathing, insurance may cover a portion of the procedure. According to ASPS statistics, more than 4,800 rhinoplasty procedures were performed on patients aged 19 and under in 2022.
Breast Reduction
Surgical reduction of very large breasts can overcome both physical and psychological burdens for a teenage girl. In fact, many teenagers suffer ongoing back pain due to overly large breasts. Although waiting may prolong the psychological awkwardness, it is advisable to delay surgery until breast growth ceases in order to achieve the best result. Insurance reimbursement is often possible with this procedure. In 2022, more than 5,900 breast reductions were performed on patients aged 19 and under.
Gynecomastia Surgery (Male Breast Reduction)
Teenage boys with large breasts, a condition known as gynecomastia, are often eager to undergo plastic surgery. Surgical correction, which can be accomplished in a variety of ways, is occasionally covered by insurance. Gynecomastia surgery accounted for 2,900 procedures in patients aged 19 and under in 2022.
Otoplasty (Ear Surgery)
Surgical correction of protruding ears, in which the ears are pinned back, may be performed any time after the age of five. In 2022, there were more than 1,700 otoplasty procedures performed on patients 19 and under. Insurance reimbursement for otoplasty is possible, but typically only occurs in extreme cases.
Skin Treatments and Resurfacing
Acne eruptions may be controlled by the proper use of modern prescription drugs. In addition to supervising the use of these medications, plastic surgeons may improve acne scars by smoothing or "refinishing" the skin with a laser or with sanding techniques such as dermabrasion or microdermabrasion. In 2022, more than 197,000 skin treatments involving lasers were performed on patients aged 19 and under, while these patients also accounted for more than 5,400 skin resurfacing treatments like dermabrasion, microdermabrasion and chemical peels.
Considerations Before Plastic Surgery
Although millions of people have plastic surgery every year without complications, no surgical procedure is risk-free. When considering plastic surgery, a person's motivation is generally driven by the expected result rather than the surgical process. ASPS urges teenagers contemplating plastic surgery, as well as their parents or guardians, to consider the following:
Certification
Patients should be sure their plastic surgeon is certified by the American Board of Plastic Surgery (ABPS). All ABPS-certified physicians have:
- Graduated from an accredited medical school.
- Completed at least six years of surgical training, with at least three years in plastic surgery.
- Passed comprehensive written and oral exams.
Accreditation
ASPS requires that all members who perform surgery under anesthesia other than minor local anesthesia and/or minimal oral tranquilization must do so in a facility that meets at least one of the following criteria:
- Accreditation by a national or state-recognized accrediting agency/organization such as the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), the Accreditation Association for Ambulatory Health Care (AAAHC) or the Joint Commission on Accreditation of Healthcare Organizations
- Certified to participate in the Medicare program under Title XVIII
- Licensed by the state in which the facility is located
By choosing an ASPS Member Surgeon, you are guaranteed that your physician meets the above certification and accreditation requirements.
Informed Consent
Even at the highest level of care, every surgery has risks as well as benefits. ASPS recognizes the physician-patient relationship is one of shared decision-making. This decision-making process is called informed consent. All information about the procedure should be discussed by the plastic surgeon and understood by the patient, as well as the patient's parents or guardian. This includes details of the surgery, benefits, possible consequences and side effects of the operation, potential risks and adverse outcomes, alternatives to the procedure being considered and the anticipated outcome. For more information on informed consent, patients are encouraged to talk with their plastic surgeon.
Please visit PlasticSurgery.org for referrals to ASPS Member Surgeons and to learn more about cosmetic and reconstructive plastic surgery.
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 11,000 members worldwide, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 92 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by ehe American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
This document is designed to provide accurate and authoritative information on the topic covered as of the date of publication and is subject to change as scientific knowledge, technology and practice patterns evolve. The views expressed represent the collective, but not necessarily the individual, views of members of the American Society of Plastic Surgeons.
Additional Resources
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- McGrath, M.H. and Mukerji, S. Plastic surgery and the teenage patient. Journal of Pediatric & Adolescent Gynecology 2000; 13:105-118.
- Pearl, A. and Weston, J. Attitudes of adolescents about cosmetic surgery. Annals of Plastic Surgery 2003; 50:628-630.
- Rosen, D. Question from the clinician: Adolescent gynecomastia. Pediatrics in Review 2003; 24:317-319.
- Sarwer, D.B. Plastic surgery in children and adolescents. In: Thompson, J.K., Smolak L. (eds.). Body image, eating disorders and obesity in children and adolescents: Theory, assessment, treatment and prevention. Washington, DC: APA Press, 2001, pp 341-366.
- Sarwer, D.B., Wadden, T.A. and Whitaker, L.A. An investigation of changes in body image following cosmetic surgery. Plastic and Reconstructive Surgery 2002. 109:363-371.
- Sheerin, D., Morag, M. and Kusumakar, V. Psychosocial adjustment in children with port-wine stains and prominent ears. Journal of the American Academy of Child & Adolescent Psychiatry 1995. 34:1637-1647.
- Simis, K.J., Hovius, S.E.R., Beauford, I.D., Verhulst, F.C., Koot, H.M. and the Adolescence Plastic Surgical Research Group. After plastic surgery: Adolescent-reported appearance ratings and appearance-related burdens in patient and general population groups. Plastic and Reconstructive Surgery 2002. 109:9-17.
- Simis, K.J., Verhulst, F.C. and Koot, H.M. Body image, psychosocial functioning and personality: How different are adolescents and young adults applying for plastic surgery? Journal of Child Psychology & Psychiatry 2000; 42:669-678.
