Yes, some teens are ripe for plastic surgery

Is plastic surgery the right choice for adolescents? One plastic surgeon, speaking to an audience of pediatricians, says "maybe."

"This is a particularly vulnerable population," cautioned Julia Corcoran, MD, attending plastic surgeon at Children's Memorial Hospital in Chicago. "They are adults in so many ways, but not in all."

Adult or not, teenagers make up a growing segment of the plastic surgery population. Surgeons performed about 335,000 cosmetic procedures in 2003, Dr. Corcoran told the AAP 2004 National Conference and Exhibition. That was about 4% of total cosmetic procedures performed in the US - up from 2% in 2002.

About 70% of these procedures are minimally invasive treatments performed in the office, without anesthesia, to enhance facial appearance. Rhinoplasty is the most popular surgical procedure, followed by otoplasty, breast augmentation, and gyneocomastia surgery.

Teens request cosmetic surgery for different reasons than adults do, Dr. Corcoran noted. Adults see cosmetic surgery as a way to stand out, to make themselves look distinctive. Teens perceive surgery as a way to fit into the group and meet peer expectations of appearance. Nose and ear restructuring are the most common procedures among teenagers, Dr. Corcoran explained, because those are the most obvious features and the most common source of teasing or ridicule by peers.

Because of his or her age, both the teen patient and parents must give informed consent before cosmetic surgery. Dr. Corcoran said that she often talks to the prospective patient apart from parents to assess the teen's expectations and appropriateness as a candidate more accurately.

"If the teen can express the problem and what they want done, they are probably an appropriate candidate for cosmetic surgery," she said. "The key is that there be a real issue that can be addressed by cosmetic surgery. And the patient has to be emotionally and physically mature enough for the procedure."