Question of the Week
June 21, 2004


What's the hot gift this year?

"June 14, 2004 -- Forget the convertible. A boob job is the latest must-have on your teen daughter's graduation list. The number of 18-year-olds who underwent breast-implant surgery nearly tripled last year � from 3,872 in 2002 to 11,326 in 2003, according to the American Society for Aesthetic Plastic Surgery. 'There is a trend in which parents are giving implants as a gift, including as a graduation present,' said Dr. Stephen Greenberg, who practices in Woodbury, L.I., and Manhattan. Popular, well-endowed teen idols, like Britney Spears and Lindsay Lohan, as well as reality-TV shows like 'Extreme Makeover' and 'The Swan,' have made some girls dislike their own bodies, experts said. 'The media and fashion industries emphasize breasts and a curvaceous figure,' said Dr. Leroy Young, co-chair of the American Society for Aesthetic Plastic Surgery's breast-surgery committee. 'There's no advertising [for implants] targeting that age group, but the images are all around them.'"

Some people appear to be getting the looks they want in just a few minutes on TV; while others in front of the camera have already been through the process. The illusion is that plastic surgery can transform anyone into someone who looks like the cover of a magazine.

"What Is Plastic Surgery?
Taken from the Greek word "plastikos", meaning to mold or give form, plastic surgery is the specialty of medicine dedicated to restoring and reshaping the human body. It encompasses both reconstructive surgery, which is performed on abnormal structures of the body caused by birth defects, developmental problems, injuries, infection, tumors or disease; and cosmetic surgery, which is performed to reshape or restore normal structures of the body to improve appearance and self-esteem.*
*Definition as adopted by the American Medical Association (AMA) and the American Society of Plastic Surgeons (ASPS)."

More and more teens are choosing "cosmetic surgery, which is performed to reshape or restore normal structures of the body to improve appearance and self-esteem."

"The most common procedures teens choose include laser hair removal, nose reshaping, ear reshaping (known as otoplasty), and breast reduction. Procedures like dermabrasion (in which the top layers of skin are surgically scraped away) can smooth severe scars from acne. Laser hair removal can, over the course of several treatments, significantly reduce unwanted body hair. A teen may decide to have his ears reshaped if they stick out from his head a lot or opt for cosmetic surgery to correct a large bump on his nose. And, despite what you may think, breast reduction is an option for both girls and guys. Girls who develop very large breasts when they go through puberty may have back pain and be uncomfortable with their appearance. Making the breasts smaller can ease strain on the back, help them stand up straighter, and make them feel less self-conscious. Breast reduction can be even more of an issue for guys...."

Yes, more and more guys are choosing cosmetic surgery these days, as well.

" are flocking to plastic surgeons for treatments ranging from Botox injections and liposuction to eye lifts and breast reductions.... Consider these statistics from the American Society of Plastic Surgeons: * In 2001, 17 percent of patients having chemical peels were men, up from 4 percent in 1992. * During that same nine-year period, the number of men having facelifts climbed from 7 percent to 10 percent. * Males opting for liposuction rose from 13 percent to 18 percent. * And men who chose to reshape their nose jumped from 28 percent to 37 percent.... Miller has seen a dramatic increase in male patients, who made up just 10 percent to 15 percent of his practice in the mid-1990s but now account for 35 percent to 40 percent."

Women, men, and teens all over the world...

"South Korea's primary cosmetic obsession is with the eyes. Having bigger eyes is every girl's dream, and it can now be realized through a simple $800 operation... Teenagers as young as 14 are doing it, and eye jobs have become a favorite high school graduation gift from proud parents. Clinics are busiest during winter vacations, when high school seniors are preparing themselves for college or for entering the workplace. The majority come for the eyelids, but nose jobs are also becoming popular among teens.... And with so many young people having themselves remade, parents are afraid their children will fall behind, not just academically but aesthetically. 'Parents make their kids get plastic surgery,' says Dr. Shim Hyung Bo, a plastic surgeon practicing in Seoul, 'just like they make them study.'"

So what do you do when so many people have altered their appearance that "normal" and "abnormal" begin to blur? The surgery is not reconstructing anything with which there has been a medical problem. It is still cosmetic surgery.

"Cosmetic surgery is performed for aesthetic rather than medical reasons. People elect to have cosmetic surgery to improve their appearance. Like any form of surgery, cosmetic surgery carries risks. In some cases, the results are not what the patient anticipated. It is vital to choose a qualified and experienced surgeon. Ask questions about possible side effects and complications."


"Last week, the FDA released its new consumer handbook on implants - and included graphic photos of possible side effects. Kathy Keithley Johnston, executive director of Toxic Discovery, an anti-implant group in Columbia, Mo., praised the FDA booklet, noting, 'a picture is worth a thousand words.' That parents willingly shell out $3,500 to $7,000 for a daughter's implant surgery infuriates Johnston, a registered nurse who claims her implants made her seriously ill. 'They say it's the girls making the decisions - but it's the parents writing the checks. How is that any different than buying them alcohol or cigarettes. Shame on any parent that would endanger a teenager that way.'"

There are parents who push their teens to have cosmetic surgery, and there are parents who encourage the surgeries by offering to pay. While some teens consider this the greatest gift a parent could give, there are those who find it irresponsible because of the risks involved.

"According to the U.S. Food and Drug Administration, the risks of breast implants don't end with the initial surgery. Since implants do not tend to last a lifetime, follow-up surgeries are often required. Some breast implants can rupture or deflate within the first few months, according to the FDA. Others will deflate after several years and some will last 10 or more years before they rupture or deflate."
ABC News

So implants are not a permanent fix. What about other procedures? For more details about other specific forms of cosmetic surgery, you can visit:
"This page offers a general overview of cosmetic surgery procedures.... While this section explores cosmetic surgical offerings, many of these procedures may also fulfill true medical needs. You should understand that the circumstances and experience of every individual will be unique.... In addition, please note that all surgery carries some uncertainty and risk, including the possibility of infection, bleeding, blood clots, and adverse reactions to the anesthesia...."

"[T]hese procedures may also fulfill true medical needs."

Whether there is a medical need, a strong desire to help self-esteem, or it is a choice for purely aesthetic reasons- parents, teens, and doctors need to look at the benefits and the risks.

"And remember that doctors will only perform some procedures once the patient has reached a certain age. Ears can be operated on when a person is fairly young, usually between 4 and 14 years old. But many doctors hold off reshaping noses until teens have completed their growth spurt - that may mean 14 or 15 for girls and a little older for guys. Breast reduction also should wait until the breasts have fully developed, and girls who want to enlarge their breasts for cosmetic reasons usually must be at least 18 because saline implants are only approved for women 18 and older."

Finding a doctor who will bend the rules a bit when it comes to age (or anything else) might seem like just what you are looking for, but keep in mind that the guidelines are there for a reason. You want a doctor that doesn't just want your business, but is also interested in your best interests and overall health.

"A board-certified plastic surgeon is a doctor trained to be a concerned care-giver, a wound-care expert, a problem-solver, an artist-designer and a meticulous surgeon in the operating room. It's important to realize that not every doctor who has claimed the title "plastic surgeon" has the same training. The truth is, anyone with a medical degree can call himself or herself a plastic surgeon; there are no laws that require doctors offering specialty care to meet certain qualifications."
American Society of Plastic Surgeons

There are many reasons to choose plastic surgery.
There are also many risks.

Questions of the Week:
What are some reasons why a teen might want plastic surgery? What are some reasons why a teen might want to decide against plastic surgery--or possibly postpone it? What are realistic expectations for a teen considering surgery? What risks and side effects should anyone who is considering plastic surgery research? Who is responsible for finding the best doctor and researching (then understanding) the possible complications? What role should the parents play in this decision? By supporting (financially or otherwise) whatever decision the teen makes, is the parent being irresponsible--or understanding and supportive?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

[email protected]
Health Community Coordinator
Access Excellence @ the National Health Museum

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