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approval; May, 2000). Many teenagers who want breast augmentation have one breast that is larger than the other – sometimes a full cup size or more in difference. This condition is called breast asymmetry. Using a saline-filled implant in the smaller breast allows the patient to have breasts of the same size. Although waiting may prolong the physical awkwardness, it is advisable to delay surgery until breast growth ceases in order to achieve the best result. Breast augmentation made up less than 5 percent of the total number of cosmetic surgical procedures performed on this age group in 2003, with 3,841 procedures. Breast Reduction Surgical reduction of very large breasts can overcome both physical and psychological burdens for a teenage girl. In fact, many teenagers suffer ongoing back pain due to overly large breasts. Although waiting may prolong the psychological awkwardness, it is advisable to delay surgery until breast growth ceases in order to achieve the best result. Insurance reimbursement is often possible with this procedure. In 2003, 16,085 patients age 18 or younger had breast reductions, accounting for 15 percent of all breast reductions performed in 2003. Acne and Acne Scar Treatment Acne eruptions may be brought under control by the proper use of modern prescription drugs. In addition to supervising the use of these medications, plastic surgeons may improve acne scars by smoothing or “refinishing” the skin with a laser or with a sanding technique called dermabrasion. In 2003, nearly 3,000 dermabrasion procedures were performed on patients age 18 or younger. Treatments for other acne related skin problems include microdermabrasion and chemical peels. In 2003, more than 74,000 microdermabrasion procedures were performed on patients 18 or younger, accounting for 29 percent of all cosmetic minimally invasive procedures for this age group. Chemical peels made up almost 50 percent of cosmetic minimally invasive procedures in this age group, with 126,327 procedures performed in 2003. Correction of Enlarged Breasts in Boys Teenage boys with large breasts, known as gynecomastia, are often eager to undergo plastic surgery. Surgical correction, accomplished in a variety of ways, is occasionally covered by insurance. Gynecomastia accounted for almost 4 percent of cosmetic surgical procedures for patients age 18 or younger in 2003, totaling more than 3,000 procedures. Additional information on these procedures can be found on the ASPS Web site at www.plasticsurgery.org. Considerations Before Plastic Surgery Although millions of people have plastic surgery every year without complications, no surgical procedure is risk-free. When considering plastic surgery, a person’s motivation is generally driven by the expected result rather than the surgical process. ASPS urges teenagers contemplating plastic surgery, as well as their parents or guardian, to consider the following: Certification Patients should be sure that their plastic surgeon is certified by the American Board of Plastic Surgery (ABPS). All ABPS-certified physicians have: • Graduated from an accredited medical school; • Completed a combination of at least five years of general surgery and plastic surgery residency training; and • Passed comprehensive written and oral exams. Accreditation ASPS requires that all members who perform surgery under anesthesia, other than minor local anesthesia and/or minimal oral tranquilization, must do so in a facility that meets at least one of the following criteria. • Accreditation by a national or state recognized accrediting agency/organization such as the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), the Accreditation Association for Ambulatory Health Care (AAAHC), or the Joint Commission on Accreditation of Healthcare Organizations (JCAHO); • Certified to participate in the Medicare program under Title XVIII; or • Licensed by the state in which the facility is located. Informed Consent At the highest level of care, every surgery has risks as well as benefits. ASPS recognizes the physician-patient relationship is one of shared decision-making. This decision-making process is called informed consent. The ASPS “Statement of Principle on Informed Consent” details the information that should be discussed and understood by the patient as well as the patient’s parents or guardian, including: details of the surgery, benefits, possible consequences and side effects of the operation, potential risks and adverse outcomes as well as their probability and severity; alternatives to the procedure being considered and their benefits, risks and consequences; and the anticipated outcome. For more information on informed consent, patients are encouraged to talk with their surgeons. To assist people considering plastic surgery ASPS has developed a brochure, “Make the Right Choice,” which offers information on managing expectations and questions to ask before plastic surgery which can be found on the ASPS Website. Visit www.plasticsurgery.org, for referrals to ASPS Member Surgeons and to learn more about cosmetic and reconstructive plastic surgery. ASPS is the largest organization of board-certified plastic surgeons in the world and the foremost authority on cosmetic and reconstructive plastic surgery. With nearly 6,000 members, more than any other
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