Although plastic surgery is becoming much more commonplace recently, when it comes to teenagers, caution is still the overriding theme that must be in place. Teenage years are extremely tough. Hormones are kicking in, growth patterns are fluctuating with unexpected growth spurts, emotions run wild, and now, with the ubiquitous nature of social media, there is really no place to hide. I can remember feeling sorry for Chelsea Clinton when her father was president. She not only had to face her usual friends and school with her awkwardness of being a teenager, but she was on display for the entire country to see. How awful. Many teens are driven to consider plastic surgery to solve their woes. My advice: put on the brakes.
Teenagers are complex monsters. Yes, I said “monsters”. Whether we are talking boys or girls, the teenager often resembles a different species. I won’t go into all the external manifestations of struggling through the teens, as most of us have been there personally and/or with our children, but it is also important to consider the internal struggle these creatures go through. New ways of thinking emerge and new fears/worries develop. One paramount issue is that of appearance. If they happen to live in vacuum, they will only deal with their own thoughts on this issue. Unfortunately, other factors, like pop culture, friends’ thoughts and many unnamed influences affect the developing self-image of a teenager. When they realize that one area may not be developing like it should, or like they think it should, whether this is real or only perceived as such, it can grow to become such a problem that it is like a thorn in the sole of the foot and can take hold of every waking thought in a teenager’s life. As parents, we want to take away any pain our children experience. One option when it comes to appearances may be plastic surgery. However, much needs to be explored before plastic surgery in teens becomes a viable and recommended option.
I believe there are at least 6 important factors to consider when working through plastic surgery options with teens:
- Maturity level
- Psychological impact
- Long term outcomes vs. short term gain
- Education of the teen and family
One trouble with the teenage years is that they are awkward. Time will usually help this out. Growing up, I had an enormous nose for the size of my face. Eventually, the size of my face caught up to the size of my nose. It would’ve been very tempting to consider plastic surgery when I was 13, but my mother who was a nurse, knew of the normal growth patterns of teens and just encouraged me to change my focus to other things I could control, while the growing took place. We live in an instant gratification society these days. Teens face this on a normal level anyway, but with the advent of recent technology, the idea of the immediate solution to a problem is immensely ingrained into their way of thinking. However, when dealing with appearances, especially those parts dependent upon normal growth patterns and puberty (like noses, breasts, acne, etc.), often “tincture of time” can lead to the best long-term results. It would be disastrous to operate prematurely on a body part that is not through growing. For instance, if a rhinoplasty (nose surgery) was performed too soon, this could lead to damage of the normal growth pattern and lead to severe disfigurement for the remainder of the patient’s life. While a short term correction of a complication may be obtained, long term detrimental effects might ensue. That being said, I have seen instances when surgery performed on teens for severely asymmetric breasts or macromastia (overly large breasts) have been beneficial. Many of the other factors were also addressed in these individuals.
The hormonal fluctuations during the teenage years can lead to growth spurts and emotional outbreaks. What seems like an insignificant problem can become “the end of the world” for a teenager. This has to be taken into account when discussing plastic surgery with a teen. In my office, I like to visit with a teen on multiple, separate occasions to ensure the emotional component is not the overlying feature that is driving the interest in surgery. Hormones also contribute extensively to the growth of an individual. If hormones are delayed or decreased, normal growth might not take place. Instead of offering plastic surgery for, as an example, underdeveloped breasts, evaluation of hormone levels and exploration of methods of correction might be a better solution than surgery.
Maturity and teens
Maturity level often goes hand in hand with growth and hormone levels, etc. Some individuals are just more mature than others. Girls tend to mature a little earlier than boys, both physically and emotionally. I’m referring specifically to the emotional/mental maturity level of the teen. For an individual to consider surgery, there has to be a level of maturity to understand the impact of their decisions, to fully understand all the risks and benefits of surgery, and to make a conscious, well educated, fully thought out decision about the changes requested with his/her body.
Just like many of my patients who consider a mommy makeover, it is important for teens to understand the psychological impact surgery can bring to them and what it can’t do. Surgery will not turn you into someone you are not. It also won’t give you what you don’t already have. It must be used to enhance self-confidence, not provide it.
Long term outcomes vs. short term gains
A point made in a slightly different way above, but bears restating a bit differently: It is difficult for all of us, but especially teenagers, to consider the long term impacts of changing our appearance with surgery. When discussing the specifics of the surgery, requests should be made with the long term mindset approach. What may look great for a few years, may become a problem in later years. Large breast implants are a perfect example. While they may seem attractive right now, choosing implants that are too large for the body, will likely lead to certain issues in the future (stretched out skin, heavy droopy breasts, need for further surgery). Also, it is imperative the patient understand that the healing process is called a process for a reason… it takes some time for the body to respond and heal from the surgery. It is NOT like getting your hair cut. Some plastic surgery procedures may actually look worse in the short term in order to have longer lasting attractive results. A breast lift, for example, take about 3-4 months to see the final results. Liposuction is similar at 3-6 months before all the swelling dissipates. Although not as common in teens, facial rejuvenation surgery is one of the prime examples of looking slightly worse before looking better.
That leads nicely into the last category of education. A patient, and his or her family, should be fully informed of the risks and benefits of the surgery, healing process time frame and level of pain to expect from the surgery. Only by going into this endeavor with eyes wide open is a patient able to set themselves up for a successful outcome. Rushing into surgery almost guarantees a disconnect on expectations and expected outcome and that is a recipe for an unhappy patient, no matter how attractive the result is.
Plastic surgery can be life changing. When used for the right reasons, with the right preparation and right mindset, it can be a gift that can improve one’s life for years to come. Since teens tend to be going through a storm of emotions and hormones, I often find it best to delay surgery until all 6 criteria listed above have been met in both them and their parents.