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skin

Doctor, make me beautiful,said the fifteen year old.
Is fifteen too young for breast implants? Absolutely. Is it too young for a nose job? Maybe. Is it too young to have your ears placed back or have a conspicuous birthmark removed? No.

An alarming trend in the United States is the increase in teenage plastic surgery. It has always seemed like children are in a rush to grow up. They have role models—young actors and singers featured in movies and regular television shows, some of whom have best selling (or downloaded) records on the pop charts. These fast living “beautiful people” are role models, whether they like it or not.

Keep in mind, if you ask a female teenager if she is happy with the appearance of her body, 80 percent will say “no”. If you ask those same people in their college years, 80 percent will say yes. Age twelve through twenty is a volatile few years for attitudes and self-image. Doing too much too soon may be a mistake that lasts a lifetime. On the other hand, denying people procedures that can make their outsides match their insides, make them more comfortable with themselves, and help them become who they were meant to be in these formative years must be considered. Guidance must come from two main sources here—the parents and the doctor. That’s why choosing an experienced, ethical surgeon is crucial.

In consultation, I am often faced with a teen-aged patient who is tormented with something he or she feels is “off” with their looks. It isn’t uncommon for tears to flow with a crescendo of emotions. The youngster’s parents are in attendance, being as supportive and non-judgmental as possible. And I become the deciding vote, which is a position of huge responsibility. I think about it a lot before I even go into the examining room. There are so many variables, thus I have no hard and fast rules. I try to have an open mind about the following three factors—age, family support, and type of surgery.

Age
Is fifteen too young for breast implants? Absolutely. Is it too young for a nose job? Maybe. Is it too young to have your ears placed back or have a conspicuous birthmark removed? No.

Liposuction is yet another story. Body sculpting such as liposuction isn’t for teens. Fat distribution can be altered by exercise and diet. Someone so young hasn’t had time to explore all the possibilities. This is one of those times when surgery is a last result and should only be done on someone in their twenty’s.
Breast implants are a life-long decision. There are just way too many body and emotional changes in the next few years to advise breast implant surgery for a teen. The few people I have seen ask for it in the teenage years were mentally and emotionally poor candidates for surgery (at any point). Often they are the children of plastic surgery obsessed mothers. These young ladies have no reasonable role model and are probably in for a life of dysfunction. I want no part of that. The best thing I can do for such a young woman is tell her, “No”. It may be the first time in her life she has heard it.

When faced with a teen who wants a rhinoplasty (nose job), I study the face. Some teenage faces are quite mature. Facial bone structure is set and the baby fat has gone away. Often these young girls are models or actresses and could easily be mistaken for being quite a bit older. If her attitude and expectations are as mature as her appearance, and the rest of the picture is in order (“support”), and I am comfortable with the surgical/aesthetic goals, I might do it.

Congenital defects are in an entirely different league. Ears that stick way out are prime examples. Such children are often the targets of merciless teasing. They are sometimes raised in a family in which everyone has already had the procedure (surgery) done. One of my most memorable patients was a little boy of ten. As he sat across the desk from me, I could see only his head. He calmly, eloquently, and concisely described his motivation for wanting the surgery and his expectations. All the while, his parents sat quietly behind him, appropriately beaming with pride. He got his surgery and probably went on to great things.

Birth defects, conspicuous birthmarks, or trauma reconstruction fit into the same category. As early in life as these patients can have a good result, they should have the option of surgery if they want it. Yes, by that I mean that even in the pre-teen years, surgery can be a reasonable option.

Support
Family support and a normal family structure (whatever that is) is vitally important. If there is a hint of dysfunction, like strange attitudes about plastic surgery or relationship issues, I pull back when it comes to recommending surgery. Absent parents or those who are all too present and overbearing are red flags for me. If the parents’ attitudes about plastic surgery are mainstream, I feel better about doing the surgery. When the parents appear to be plastic surgery obsessed, I become far more reluctant to perform the operation on their children.

Surgery
By this, I mean the type of surgery and at what age I am willing to perform it. As I stated above, teens are too young for breast implants. I am not even in favor of doing it at eighteen for some patients. But breast reduction is another story.

Unlike the desire for larger breasts (breast augmentation), women with huge breasts are being held hostage by their own bodies. They cover up, avoid athletics, and often shun relationships. They feel conspicuous and embarrassed most of the time. The surgery frees them. It allows them to be the outgoing fun people they are inside. As long as my patient is in the later teen years and the breast growth seems to have stabilized, I will offer the surgery if the support system is present.

So when the fifteen year old says “Doctor, make me beautiful!” I sit back, keep an open mind, and listen. Sometimes I say, “Let’s let nature take its course.” Other times it’s “Let’s give nature a little help.”

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"Doctor, make me beautiful,said the fifteen year old."
   authored by:
PLASTIC SURGERY
Dr. Andrew Ordon, MD, FACS is a Plastic Surgeon and one of the Co-Stars of the Emmy winning syndicated television series, "The Doctors.” He has two successful practices in Beverly Hills and Rancho Mirage, California and he is a founding member of the...



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