American Society of Plastic Surgeons Weighs in On Growing Popularity of Teen Plastic Surgery
Newly-Published Recommendations Explain When Plastic Surgery Is and Isn’t Okay for Teens

ARLINGTON HEIGHTS, IL – In an age of selfies and constant social media sharing, a growing number of teenagers are undergoing plastic surgery to alter their appearance. According to statistics from the American Society of Plastic Surgeons (ASPS) about 229,000 cosmetic procedures were performed on patients aged 13 to 19 in 2017, though research by board-certified plastic surgeons Rod J. Rohrich, M.D. and Min-Jeong Cho, M.D. of the Dallas Plastic Surgery Institute found that very few guidelines are in place to ensure teen plastic surgeries are performed appropriately.

Currently, teenagers account for about four percent of all cosmetic surgery procedures, with the most common procedures among teens being nose reshaping, male breast reduction and ear surgery. Adolescents also account for a small percentage of total nonsurgical cosmetic procedures, such as laser hair removal, skin resurfacing and Botox injections, but in a new paper published in the September issue of Plastic and Reconstructive Surgery®, Drs. Rohrich and Cho warn that while these procedures are frequently performed on adults with minimal side effects, performing them on adolescents should be done with extreme caution.

"While a rhinoplasty or ear surgery can be performed safely by a board-certified surgeon and are, in many cases, appropriate for an adolescent, other cosmetic procedures such as breast augmentation, liposuction or injectables are typically not recommended for minors for several reasons, including lack of research," said Dr. Rohrich. "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."

Although today's social media-obsessed culture has contributed dramatically to a rise in plastic surgery, teenagers seek plastic surgery for a variety of reasons, ranging from addressing a health need to fixing a feature that has made them susceptible to bullying. The American Society of Plastic Surgeons emphasizes the importance of understanding a teen's motive for surgery and ensuring that every potential teenage patient undergoes a careful and extensive preoperative evaluation to ensure they are an appropriate candidate for their desired procedure.

"Despite its growing popularity, guidelines and outcome studies for teenage plastic surgery have previously not existed," explains Dr. Cho. "Our research exposed a need for stringent guidelines, particularly when it comes to determining when a procedure is appropriate to perform and the recommended age for each procedure, so that's what we set out to deliver."

Most notable of the guidelines are age considerations, which vary based on each procedure and the growth and development of the area of the body being operated on. Additionally, the doctors reinforce the important steps that should be taken when assessing underage patients, including obtaining parental consent, determining the physical and emotional maturity of the patient and discussing their desires, goals, risks, expected postoperative course, limitations and complications of the procedure.

Guidelines for the most popular procedures, include:

• Rhinoplasty: In children and teens with significant nasal deformities, nose reshaping may be recommended. It is recommended that surgery not be performed until nasal growth is completed – typically age 15 to 16 in females and age 16 to 18 in males. In some situations, such as a child with a cleft lip, a rhinoplasty may be performed at a younger age.
• Breast reduction: To alleviate back and neck pain, a breast reduction is commonly performed on teen girls; however, it's important to ensure that surgery is performed after the patient has completed breast development, which typically occurs between 12 and 19 years of age. Additionally, breast enlargement can be a temporary problem in adolescent boys, but is sometimes treated by male breast reduction if it has not resolved in the early teen years.
• Otoplasty: Surgery to correct ear deformities can be performed as young as age five, as this is when the ear is almost fully grown.
• Liposuction: Unless performed as part of a breast reduction surgery, it is not recommended that a teenager undergo liposuction.
• Breast augmentation: Candidates with uncommon chest deformities or congenital breast asymmetry are generally the only cases in which a board-certified plastic surgeon should deem breast augmentation appropriate for a teenager. It's important to note the Food and Drug Administration approved saline-filled breast implants for breast augmentation in women age 18 or older and for breast reconstruction in women of any age. The FDA approved silicone-filled implants for women age 22 or older.

Any patient who is considering a plastic surgery procedure should consult with a board-certified plastic surgeon. For help finding a surgeon in your area visit www.plasticsurgery.org. For more information on teenage plastic surgery, including video interviews with a surgeon and teenage patient, images and more visit http://plasticsurgery.org/media-portal and enter password "asps".

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

Click here to read "When Is Teenage Plastic Surgery versus Cosmetic Surgery Okay? Reality versus Hype: A Systematic Review"

Article: "When Is Teenage Plastic Surgery versus Cosmetic Surgery Okay? Reality versus Hype: A Systematic Review" (doi: 10.1097/PRS.0000000000004630)