Teens and self esteem: Is plastic surgery the answer?

E-MAIL | LINK | ADD A COMMENT (6) Posted by Lylah M. Alphonse June 12, 2009 10:42 AM

Most teenagers -- both male and female -- wrestle with self-esteem and body-image issues. Some are content to tweak their looks with fashion and makeup. Others decide to sculpt their bodies through diet and exercise. But a large number of kids, perhaps influenced by "reality" TV shows or a social pressure to look "perfect," turn to plastic surgery for a quicker fix.

Of course, parents will do almost anything to help their teens feel better about themselves. But is paying for elective plastic surgery taking things too far?

I'm not talking about reconstructive surgery, I'm talking about plastic surgery for cosmetic reasons: Rhinoplasty (nose jobs). Liposuction. Breast enhancement. Botox. You know -- procedures that are supposed to "improve" one's looks and, many people assume, bolster one's self esteem.

In "Real Girls, Real Pressure: A National Report on the State of Self-Esteem, a survey of more than 1,000 girls in the United States showed that 70 percent of girls ages 8 to 17 believed that they "are not good enough or do not measure up in some way, including their looks, performance in school and relationships with friends and family members." The survey, which was sponsored by the Dove Self-Esteem Fund (part of Dove's Campaign for Real Beauty and in partnership with the Girl Scouts of America), also found that 75 percent of girls with low self-esteem have eating disorders or engage in negative or risky behaviors like self mutilation, smoking, bullying, or drinking (in comparison, only 25 percent of girls who felt they had good self-esteem engaged in those behaviors).

The number of cosmetic procedures performed on patients under the age of 18 has actually declined since 2001, but the most-recent (2008) stats from the American Society of Plastic Surgeons show that while the numbers for invasive procedures like breast augmentation and liposuction have dropped since 2007, minimally invasive procedures -- injections, laser skin resurfacing, chemical peels -- are on the rise. Part of the reason may be the cost: Single-site liposuction can run as much as $4,000, while a laser skin-resurfacing treatment averages about $400.

Dr. Yan Trokel, a cosmetic surgeon in New York and the founder of the Yan Center for Corrective and Cosmetic Surgery, tells me that his younger patients (under age 18) come to him for corrective, not cosmetic, surgeries (like rhinoplasties, orthognathic/jaw surgeries, and otoplasties/ear reshaping surgeries). "The procedures I perform on individuals under the age of 18 are those procedures that address anatomical imperfections," he says, adding that he will not perform rhinoplasties on patients younger than 16.

"I would be reluctant to perform a surgery for purely aesthetic reasons, such as liposuction, without first having counseled them on necessary lifestyle changes such as improved diet and exercise to achieve optimal, long-lasting results," he says.

Not all of the teens who want plastic surgery are good candidates for it. "A surgeon should properly assess physical/anatomical and psychological maturity of a potential patient and discuss possible risks and side-effects before proceeding with any form of treatment/procedure," Dr. Trokel warns.

So, would a plastic surgeon recommend a procedure to boost his own child's self esteem? Dr. Trokel, who has a baby boy on the way, says yes. "I would permit my child to undergo plastic surgery to increase their self-esteem given that the cause of concern is of an anatomically flawed nature," he says.

How far would you go to help boost your teen's self esteem?

Lylah M. Alphonse is a Globe staff member and mom and stepmom to five kids. She writes about juggling career and parenthood at The 36-Hour Day and blogs at Write. Edit. Repeat. E-mail her at lalphonse@globe.com.

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6 comments so far...

I think that certainly if my child had a glaring physical defect that could be corrected or lessened with surgery, that's one thing. Examples I can think of include a deformed ear or nose, burn scars, port-wine stains, severe acne, etc. The sort of thing that would be classified as medical and possibly covered by insurance. I had a corrective jaw reduction done in high school but it was a medical problem so insurance covered it. But a boob job? Lipo? Rhinoplasty just because my child doesn't like his/her imperfect nose? Botox? Lip plumping? Um...no. I'm not against cosmetic surgery in general - I would love a mommy makeover if I could afford it - but I don't think that teens have the emotional maturity to really decide what is and isn't important about their permanent physical appearance. If one of my kids had plastic surgery as an adult, and paid for it themselves, then whatever but I certainly wouldn't encourage such superficiality at such a young age by financing and approving of cosmetic procedures for a minor child.

Posted by Jen June 12, 09 03:51 PM

A lot of people who have bad body images still have them after surgery. And frankly, other high school kids are not kind to teenagers who go to plastic surgeons for "NJ's." We used to joke about the girls who had "bathtub accidents" over spring break and came back with nose bandages.

Posted by Remembering Julie's NJ June 12, 09 09:21 PM

I was under some pressure from family members to undergo rhinoplasty as a teenager (the women in my family generally get their noses 'fixed' at some point). However, I resisted because I was afraid of the surgery and thought I could live with the way I looked. But then, I also resisted getting my ears pierced or getting inked as I got older...I'm just not into body modification of any kind.

I think it's important to support a child's self-esteem in many ways, and not just his or her physical attributes. We are waaaay too obsessed with looks in this culture. Beauty comes in all kinds of packages, and a child/adolescent who is so hard on herself as to ask for plastic surgery may be overly fixated on others' looks - not a great attitude for the real world.

Posted by heartseek June 12, 09 10:29 PM

I agree with Jen, that I'd let a child fix a glaring physical defect. Cosmetic surgery for teens though? No way. I had a big Italian nose that I hated growing up, I thought it was my worst feature and I would have loved a nose job when I was 16. But eventually, I grew into my nose, it became proportional once my face matured and I think I'd look silly had I gotten it made smaller. I don't think cosmetic surgery should be done until around age 20, which is after the body has stopped developing and all that stupid external stuff from high school doesn't tend to matter anymore. Kids really should learn to be comfortable with who they are before making a decision that really is permanent, because you can't go back.

Posted by tina June 13, 09 06:44 AM

Who are these idiot parents who are paying for elective surgery for children? And more importantly what does it say about them and their values?

Surgery to fix a cleft palate? Of course! But a boob job? Are you KIDDING?

I'd rather have an "ugly" child who cares about IMPORTANT things like giving back to the community, education, and self esteem.

Beauty is skin deep. Some of the ugliest people I've ever met were gorgeous on the outside.

Posted by C June 13, 09 09:18 AM

I'm in with the glaring physical defect procedures - but nose jobs, breast augmentation, liposuction or even facial peels?! No. Way. Until I had a child, I was two-dimensional. No breasts, no hips - the perfect little boy figure. And I hated it, of course! But bodies change, even after we stop growing...and a16, 17, even 18 year old is still growing. As one commenter noted, as her face matured, so did the "fit" of her nose. Skin changes too. Lips fill in, most teenage acne clears up. And FWIW, I went from a training bra to a size that many women augment themselves to reach - naturally. While the baby weight may be gone, the ta-tas stayed - as did the hips. I know people don't always hit that jackpot, but really...as I've said, bodies _change_. It's part of life.

Any parent who would willingly allow a teenager to undergo cosmetic surgery purely because Sally wants bigger ta-tas or Joey wants to lose the flab has probably got serious seld esteem issues of their own...and is trying to fix them vicariously through their child rather than teaching their child to accentuate their beautiful points

What this piece did leave out was the dearth of information that actually links breast augmentation to a higher suicide rate too. Keyword search it and you'll find tons of articles and reports on this phenomena. Knowing that body modification of this nature does nothing to necessarily improve one's low self esteem, why would parents allow this over, say, positive focus on other attributes or counseling for kids whose self esteem is so low as to have become dangerous?

Posted by phe June 15, 09 10:50 AM

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about the authors

Lylah M. Alphonse is a member of the Globe Magazine staff and mom and stepmom to five kids. She writes about juggling a full-time career and parenthood at The 36-Hour Day, and about everything else at Write. Edit. Repeat. When she's not glued to the computer or solving a kid-related crisis, she's in the kitchen or, occasionally, asleep.

Contact Lylah

Barbara F. Meltz is a freelance writer, parenting consultant, and author of "Put Yourself in Their Shoes; Understanding How Your Children See the World." She won several awards for her weekly "Child Caring" column in the Globe, including the 2008 American Psychological Association Print Excellence award. Barbara is available as a speaker for parent groups.