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PLASTIC SURGERY AND ADOLESCENTS
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Teenagers and Cosmetic Surgery: Focus on Breast Augmentation and Liposuction Diana Zuckerman, Ph.D.a and Anisha Abraham, M.D., M.P.H.b,* a National Research Center for Women & Families, Washington, DC b Department of Pediatrics, Georgetown University School of Medicine, Georgetown University Medical Center, Washington, DC Manuscript received June 13, 2007; manuscript accepted April 2, 2008 Abstract Two of the most popular and controversial cosmetic procedures for adolescents are liposuction and breast implants. In this review article, the procedures are discussed. In addition, the physiological and psychological reasons to delay these procedures, including concerns about body dysmorphic disorder and research findings regarding changes in teenagers’ body image as they mature, are described. The lack of persuasive empirical research on the mental health benefits of plastic surgery for teenagers is highlighted. Finally, the long-term financial and health implications of implanted medical devices with a limited lifespan are presented. Adolescent medicine providers need to be involved in improving informed decision making for these procedures, aware of the absence of data on the health and mental health risks and benefits of these surgeries for teenagers, and understand the limitations on teenagers’ abilities to evaluate risks. © 2008 Society for Adolescent Medicine. All rights reserved. Keywords: Cosmetic surgery; Liposuction; Breast augmentation; Informed consent The number of adolescents requesting and undergoing cosmetic procedures has increased dramatically over the last decade. The American Society of Plastic Surgeons (ASPS) estimates that more than 333,000 cosmetic procedures were performed on patients 18 years of age or younger in the United States in 2005, compared to approximately 14,000 in 1996 [1]. In 2005, one in four of these were surgical procedures such as nose reshaping, ear surgery, breast augmentation, liposuction, chin augmentation, and abdominoplasty (tummy tucks). ASPS does not report demographic information specifically for adolescent patients. However, among all patients, including adults, children, and teenagers, approximately 90% are female, 20% are racial and ethnic minorities, and there is a considerable income range. Reconstructive surgery is defined as a procedure to correct a clear abnormality. Reconstructive procedures such as correction of cleft lip or palate, can provide enormous benefit to children and teenagers. In contrast, cosmetic surgery is defined as surgery to improve a “normal” appearance, such as reshaping a nose or augmenting breasts. This conceptual paper examines the impact of body image on Adolescents’ quest for cosmetic surgery. A reflective analysis of the literature was utilized. Factors shaping one’s perception of own body was explained .The causes and effects were also highlighted. The study has shown, that there has been a definite increase in the number of teenagers undergoing various cosmetic procedures and that a correlation can be drawn between this quest and poor body image, which could have alarming physical, social and emotional consequences. As for the causes the study has concluded that the quest to achieve a better appearance is mainly due to the socially portrayed “ideal beauty standards”. There is a consensus among researchers and medical practitioners that, the main pushing factor towards going under the knife is social especially enhancement procedures. It was also found that; the media and the rigorous capitalist’s campaign to boost consumerism is behind the rampant body idealization culture. In addition, the study has also shown that the availability of advanced cosmetic procedures in some countries has led to the increase of adolescents’ seeking body modifications. Keywords: Cosmetic Surgery, Body Image, Adolescents, Causes & Effects Introduction Body image is usually defined as the mental image of one‘s own body. This image is usually shaped by perception, emotions and physical sensations, as well as all the physiological and emotional changes an individual passes through during the processes of growth and socialization. In this process, all social institutions and agents, such as family, peers, school and the media, play a crucial role in creating this image. In fact, body image is fluid and can change depending on an individual‘s environment, mood and experiences. Research has shown that passing through puberty can increase one‘s concerns about his/her body image, with some level of difference between the two sexes. Being overly-concerned with body image can lead people in general and adolescents in particular to look for means to enhance their physical appearance and enable them to conform to dominating trends portrayed by many -particularly the media- outlets. ISSN 2220-8488 (Print), 2221-0989 (Online) ©Center for Promoting Ideas, USA www.ijhssnet.com 130 One of the extreme alternatives is to opt for cosmetic surgery, which may be due to the absence of proper education and orientation. Living in the age of post-modernism, which brings along with it, developments of different levels such as rapid technological development, the availability of all sorts of products and the high level of consumerism has made the human body a major focus of attention. Individuals are more concerned than ever about their health, wellbeing, longevity and -very importantly- their physical beauty. The desire to comply with society‘s idolized stereotype of beauty has become so extreme that women and men of all ages will go to great lengths to achieve that image of perfection, be it by altering their lifestyle through diet, exercise and beauty products, or by taking more drastic measures that include cosmetic surgery. Thus, the issue of body image has become an important subject of study in many different disciplines including Medicine, Nutrition, Psychology, Sociology, etc., and has become one of the hottest controversial issues faced by modern societies. Body Image and Beauty Historically, seeking a beautiful appearance has always been a preoccupation for both men and women across the different societies that have inhabited different parts of the world. It has often been said that beauty is in the eye of the beholder. However, it also has a lot to do with the beholder's cultural standards.1 In fact, looking for a socially accepted outward appearance has always been a human trait, although what is deemed beautiful and the perceptions surrounding it vary according to one‘s culture. The common feature is that beauty in general terms is a human aspiration. For instance, ―Ancient Egypt was one of the vainest ancient civilizations and one of the first nations that created perfumes, oils and other beauty treatments. Indeed, the Egyptians placed a very high emphasis on their physical appearance.‖ 2 In ancient Greece, physical beauty was highly venerated as well and those who were deemed beautiful were revered. The history of beauty is really about the history of philosophical and perceptual notions of perfection and how they have been applied to ideas and objects, as well as to the human body3 andPlato considered beauty to the Idea (Form) above all other Ideas‖.4 It is usually perceived that; seeking beauty is a preoccupation associated with women. However, in recent years, men have become increasingly interested to alter the aspects they do not like to see in the mirror. Nowadays, there is a noticeable increasing demand for cosmetic surgery among women and men equally regardless of age, especially in the developed world where the most sophisticated techniques and procedures are available, as well as possessing a socio-cultural environment that is less hostile towards
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