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national data bank age distribution. 2003; Available at: http://www. surgery.org/download/2003-stats.pdf. Accessed March 21, 2008. [9] American Society for Aesthetic Plastic Surgery. Statistics. Available at: http://www.surgery.org/press/statistics.php. Accessed March 21, 2008. [10] McGrath MH, Mukerji S. Plastic surgery and the teenage patient. J Pediatr Adolesc Gynecol 2002;13:105–18. [Briefing Papers: Plastic Surgery For Teenagers Teenagers who want to have plastic surgery usually have different motivations and goals than adults. They often have plastic surgery to improve physical characteristics they feel are awkward or flawed, that if left uncorrected, may affect them well into adulthood. Teens tend to have plastic surgery to fit in with peers, to look similar. Adults tend to have plastic surgery to standout from others. Common physical characteristics or concerns teenagers wish to correct include nose reshaping, protruding ears, overly large breasts, asymmetrical breasts, and severe acne and scarring. Teens frequently gain self esteem and confidence when their physical problems are corrected. In fact, successful plastic surgery may reverse the social withdrawal that so often accompanies teens who feel different. According to American Society of Plastic Surgeons (ASPS) statistics, more than 331,000 cosmetic plastic surgery procedures were performed on people age 18 or younger in 2003. Not every teenager seeking plastic surgery is well suited for an operation. Teens must demonstrate emotional maturity and an understanding of the limitations of plastic surgery. In addition, certain milestones in growth and physical maturity must be achieved before undergoing plastic surgery. With the introduction of reality plastic surgery shows like MTV’s “I Want a Famous Face,” the ASPS cautions teenagers and parents to keep in mind that plastic surgery is real surgery, with great benefits, but also carries some risks. Teens should have realistic expectations about plastic surgery and what it can do for them. Patients should be cautious of any physicians claiming they can make you look like someone else. Everyone has different and unique facial features and bone structure, which greatly influence the outcome of any plastic surgery procedure. Although health insurance does not pay for cosmetic plastic surgery, coverage is often provided when a procedure alleviates physical symptoms or improves a body function. Such is usually the case, for instance, when breast reduction eliminates severe back and neck pain. It should be noted, however, that health insurance coverage varies greatly between health plans. Statement The ASPS has no formal position on plastic surgery for teenagers. As with any surgery, parental consent is required for all plastic surgery procedures performed on teens younger than 18. ASPS advises parents to evaluate the teenager’s physical and emotional maturity and believes that individual cases merit careful evaluation under the guidance of a plastic surgeon certified by The American Board of Plastic Surgery. The most rewarding outcomes are expected when the following exist: The teenager initiates the request. While parental support is essential, the teenager's own desire for plastic surgery must be clearly expressed and repeated over a period of time. The teenager has realistic goals. The young person must appreciate both the benefits and limitations of plastic surgery, avoiding unrealistic expectations about life changes that will occur as a result of the procedure. The teenager has sufficient maturity. Teenagers must be able to tolerate the discomfort and temporary disfigurement of a surgical procedure. Plastic surgery is not recommended for teens who are prone to mood swings or erratic behavior, who are abusing drugs and/or alcohol, or who are being treated for clinical depression or other mental illness. Common Plastic Surgery Procedures Rhinoplasty (nose reshaping) Plastic surgery may be performed on the nose to straighten the bridge, remove an unsightly hump, reshape the tip or open breathing passages. Ordinarily this is not performed until the nose reaches its adult size – about age 15 or 16 in girls and a year later in boys. In the event of a prior injury or obstruction to breathing, insurance may cover a portion of the procedure. According to ASPS statistics, rhinoplasty was performed on 42,513 patients age 18 or younger in 2003. The procedure made up more than 50 percent of all cosmetic surgical procedures performed on this age group. Otoplasty (ear surgery) Surgical correction of protruding ears, in which the ears are pinned back, may be performed any time after the age of five. Otoplasty made up 20 percent of all cosmetic surgical procedures performed on this age group in 2003, with more than 16,000 procedures. Insurance reimbursement for otoplasty is possible, but typically occurs in extreme cases. Correction of Breast Asymmetry When one breast grows to a much larger size than the other, an operation may correct the difference by reducing the larger breast, augmenting the smaller, or both. Insurance reimbursement is occasionally possible with this procedure. Breast Augmentation Saline-filled breast implants can be used for breast augmentation in women 18-years or older and for breast reconstruction (Food and Drug Administration
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