We're seeing a rise in the number of teens getting cosmetic surgery as a reaction to external stressors like bullying and social media.

Cosmetic surgery centers have seen a rise in teens seeking cosmetic surgical solutions. For some, it's somewhat aspirational, looking to try and improve what they see as a shortcoming or achieve a specific aesthetic. For others there are darker reasions like bullying.

In a study by Lee et al. (2017), bullying is one of the main factors in teenagers getting cosmetic surgeries. The researchers found that bullied teens can have long-lasting trauma that lead to a desire to change their appearance.

One example: Ear surgery is consistently number one as the top plastic surgery procedure for the 18 and under category. (On the non-surgical end, laser hair removal is number one.)

I'm aware of a number of surgeons who report that they've been asked to perform surgeries that have been 'gifted' to children. In my mind that raises a number of concerns and there's a slight feeling of uneasiness since it's difficult to pin down where the teen-patient's desires might lie or if they've been manipulated.

In many cases it's clear; pinning back ears might make life significantly easier, but with something like breast augmentation or liposuction it's more obscure. For these situations, you might want to probe a little to try and discern motives and needs and, if you're concerned, recommend that teens wait for their bodies to mature.

Research on cosmetic surgery and teens.

In one study by Ashikali, Dittmar, and Ayers (2014), researchers gathered female teenagers to watch reality TV series that showed cosmetic surgery. They were explicit about the surgeries and risks shown on TV, but the subjects perception about getting cosmetic surgery remained strong as they believed it could change their appearance and social status, both strong motivators.

Recommendations

I don't want to get too far over my skis here but I'm going to offer some recommendations on where you might want to consider pushing back a little when asked to perform a cosmetic treatment on a teen.

Probably Appropriate

• Rhinoplasty and Otoplasty
• Breast surgeries to correct an obvious issue. Either a breast reduction to avoid back/neck pain or things like breast asymmetry.
• Gyneomastia in male teens.
• Acne treatments
• Laser hair removal

Might Ask Some Hard Questions

• Breast enhancement
• Liposuction
• Cheek or other implants
• Botox and fillers

Of course this is just my list. Happy to be schooled in the comments.

Note: Lee et al. suggest better screening methods prior to possible cosmetic surgical option. Physicians and other providers should know when to detect instances of bullying or even body dysmorphic disorder. To know more if your patient exhibits body dysmorphic, you could read more here.