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Teens and Plastic Surgery

Jeffrey Spiegel
Jeffrey Spiegel

This document discusses considerations for plastic surgeons when evaluating teenage patients who want plastic surgery. It notes that determining when a teenager is mature enough to make an irreversible decision about their appearance is challenging. While some surgeries like rhinoplasty may help boost confidence after teasing, changing one's looks may not solve deeper issues. The document suggests waiting until transitional periods like summer vacations to allow for recovery without social pressures. Overall, surgeons should investigate patient goals and whether surgery aligns with healthy development rather than superficial reasons.

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plastic surgery Teens & plastic surgery Plastic plastic surgery Surgery atnt THE BALANCING ACT OF HELPING YOUR PATIENTS MAKE THE BETTER CHOICE By Jeffrey Spiegel, M.D. Contributing Editor & Advisor What is the purpose of plastic surgery? Sounds Even if the definition of better is hard to like an easy question, but like many easy questions, pin down, we know instinctively that some plastic the more we consider the answer, the more surgery must be wrong. When an anorexic person complex the answer appears. feels he or she is overweight, we know that The easy answer is to make oneself look something is wrong. Similarly, when an attractive better. Of course, better is a very subjective word when it comes to appearance. Does piercing with a gold loop in the nose make a person look better? Even if the definition of better is Does a flower tattoo on the ankle make one look hard to pin down, we know better? Different people will offer very divergent instinctively that some plastic surgery opinions. Perhaps the same person will even offer different opinions, depending upon when you ask must be wrong. them. A 16-year-old girl who wants to fit in with her friends may feel one way while a 32-year-old person changes too many things and looks woman with small children who is trying to work unnatural, we wonder if he or she had some sort of her way up the corporate ladder may feel very image problem, such as body dysmorphic disorder differently. (bdd). aesthetictrends.com | may june 2011 1
In general, we all agree it and has suffered some juvenile There are no ways to plastic surgery that when you show certain signs teasing about her nose over the know the answers to these of aging (e.g. jowling), certain years. If she were 22 years old, questions. If she were younger, procedures, for example the decision to proceed with the decision would be easier. tightening the skin such as with a rhinoplasty would be clear. She Medically, we can decide that it facelift, are something that a comes to the office with Dad, who makes good sense to wait on reasonable person could consider. has the same nose, though it fits some cosmetic surgery until the Perhaps they feel younger than better on his 45-year-old face. body is more matured. they look and are frustrated with There are some women Certainly, we would not being treated as old beyond their with large noses who are want to do surgery, then watch all capabilities. But, what if the confident and vivacious, while our good work go undone as the patient grows, or worse, have negative effects on facial growth We would not want to do surgery, then watch all our because of the surgery. This is a good work go undone as the patient grows, or worse, commonly used reason to delay plastic surgery on certain have negative effects on facial growth. adolescents and teenagers. While a convenient and comforting reason, I am not sure that there is person with jowling wants a others are shy and meek. Did strong medical evidence that there facelift because his or her spouse growing up with a large nose cause are negative effects on growth thinks they look too old and the the meekness? Why for some following rhinoplasty. spouse wants to have a younger and not the others? Maybe both Animal studies have looking partner? How do we feel suffered ridicule and some shown no problems with facial now about the indications for developed stronger personalities surgery on growth, and many of surgery? because of it. Which way will the us have experience in surgical patient in your exam room go? repair of traumatic injuries where TEEN PATIENTS The questions get even trickier when the patient is a teenager. Teens have strong opinions and are more likely than adults to both act on impulse and misread emotions and social cues. They are also less likely to consider the adverse consequences of any decisions. So, what do we do when a teenager decides he or she does not look good and needs plastic surgery? Consider this example. A 14-year-old girl comes to the office for a rhinoplasty. Shes a pretty girl but has a large nose. Shes shy and self-conscious about 2 aesthetictrends.com | may june 2011
no unexpected craniofacial mature, it is perhaps only need to wear a plastic splint on plastic surgery abnormality resulted from the the experience of the suffering their nose for a week after surgery (or the initial trauma). that allows us to better identify surgery, or a headband following Nonetheless, it is generally and handle similar stresses. an otoplasty for several weeks. considered wise to wait until after When a person feels low They will know if they want most growth has occurred before self-esteem and suffers bullying as surgery or not after hearing about performing a procedure such as a teenager over a physical the aftercare. rhinoplasty. This helps us avoid characteristic, it is logical to want Transition periods end up sticky issues with some patients as to change that aspect of the being a convenient and advisable we can simply request they wait appearance. Unfortunately, time for plastic surgery in until they are older. changing ones appearance to teenagers. These include at the The real problem here is appease a bully is unlikely to be start of summer vacation and in deciding when a teenager is successful. Worse, it can cause a particularly between school years mature enough to make an person to lose what could when they are changing from one irreversible decision. In the law, eventually be a source of pride. school to another. The ability to teens are typically emancipated at There are no clear cut enter a new place without the age 18, although not all 18-year- answers to determining when teen concerns of the old can allow a olds are emotionally mature. surgery is appropriate; however, formerly introverted young Furthermore, people are the questions posed above will person to shine. capable of bad decisions hopefully place you into the right At my office, I have throughout their lives. As in frame of mind when considering greatly enjoyed helping people much of facial plastic surgery, the how to evaluate these requests. maximize their quality of life and key is to investigate goals and Like with all plastic surgery, it has self-esteem through motivations. to be done for the patient only, improvements in their Studies have shown that and not to please a friend (or appearance. Seeing the smile on higher than 50% of young women parent!) or appease a bully. That a teenagers face when she desire to have plastic surgery of being said, there are a few recognizes her own beauty makes some type during their lives. guidelines that can help. all the efforts involved in sorting Hopefully, this trend represents a through the motivations generally increased WHEN IS THE RIGHT TIME? worthwhile. understanding, acceptance, and Correction of a congenital comfort with the science and deformity (e.g. asymmetry, cleft, services available by well trained or similar) that still remains as a aesthetic surgeons. Perhaps the About teenager can be corrected at any youth of today recognize that time that is medically advisable. the eating right, staying fit, and finding Scar revisions, keloid treatments, Author meaning in their lives are and the like can similarly be important, and that plastic surgery addressed at any time. can occasionally provide Rhinoplasty and otoplasty improvements to areas that are are two common requests in this Jeffrey H. Spiegel, M.D., is Chief of not readily corrected otherwise. age group. Once growth issues the Division of Facial Plastic and Undoubtedly, though, for some have been decided, I prefer to Reconstructive Surgery at the Boston the desire to have plastic surgery carefully discuss the nature of the Medical Center and holds academic represents a desire to change or appointments in the Departments of surgery with the patient and run from their sense of self. Peer Otolaryngology and Head and Neck explain the recovery process. Surgery and Plastic Surgery at the pressure and the pain of taunting Teen patients are very good at and bullying become magnified Boston University School of making appropriate decisions Medicine. Visit Dr. Spiegels website during the teen years. As we once they know that they will and blog: www.drspiegel.com. aesthetictrends.com | may june 2011 3

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Teens and Plastic Surgery

  • 1. plastic surgery Teens & plastic surgery Plastic plastic surgery Surgery atnt THE BALANCING ACT OF HELPING YOUR PATIENTS MAKE THE BETTER CHOICE By Jeffrey Spiegel, M.D. Contributing Editor & Advisor What is the purpose of plastic surgery? Sounds Even if the definition of better is hard to like an easy question, but like many easy questions, pin down, we know instinctively that some plastic the more we consider the answer, the more surgery must be wrong. When an anorexic person complex the answer appears. feels he or she is overweight, we know that The easy answer is to make oneself look something is wrong. Similarly, when an attractive better. Of course, better is a very subjective word when it comes to appearance. Does piercing with a gold loop in the nose make a person look better? Even if the definition of better is Does a flower tattoo on the ankle make one look hard to pin down, we know better? Different people will offer very divergent instinctively that some plastic surgery opinions. Perhaps the same person will even offer different opinions, depending upon when you ask must be wrong. them. A 16-year-old girl who wants to fit in with her friends may feel one way while a 32-year-old person changes too many things and looks woman with small children who is trying to work unnatural, we wonder if he or she had some sort of her way up the corporate ladder may feel very image problem, such as body dysmorphic disorder differently. (bdd). aesthetictrends.com | may june 2011 1
  • 2. In general, we all agree it and has suffered some juvenile There are no ways to plastic surgery that when you show certain signs teasing about her nose over the know the answers to these of aging (e.g. jowling), certain years. If she were 22 years old, questions. If she were younger, procedures, for example the decision to proceed with the decision would be easier. tightening the skin such as with a rhinoplasty would be clear. She Medically, we can decide that it facelift, are something that a comes to the office with Dad, who makes good sense to wait on reasonable person could consider. has the same nose, though it fits some cosmetic surgery until the Perhaps they feel younger than better on his 45-year-old face. body is more matured. they look and are frustrated with There are some women Certainly, we would not being treated as old beyond their with large noses who are want to do surgery, then watch all capabilities. But, what if the confident and vivacious, while our good work go undone as the patient grows, or worse, have negative effects on facial growth We would not want to do surgery, then watch all our because of the surgery. This is a good work go undone as the patient grows, or worse, commonly used reason to delay plastic surgery on certain have negative effects on facial growth. adolescents and teenagers. While a convenient and comforting reason, I am not sure that there is person with jowling wants a others are shy and meek. Did strong medical evidence that there facelift because his or her spouse growing up with a large nose cause are negative effects on growth thinks they look too old and the the meekness? Why for some following rhinoplasty. spouse wants to have a younger and not the others? Maybe both Animal studies have looking partner? How do we feel suffered ridicule and some shown no problems with facial now about the indications for developed stronger personalities surgery on growth, and many of surgery? because of it. Which way will the us have experience in surgical patient in your exam room go? repair of traumatic injuries where TEEN PATIENTS The questions get even trickier when the patient is a teenager. Teens have strong opinions and are more likely than adults to both act on impulse and misread emotions and social cues. They are also less likely to consider the adverse consequences of any decisions. So, what do we do when a teenager decides he or she does not look good and needs plastic surgery? Consider this example. A 14-year-old girl comes to the office for a rhinoplasty. Shes a pretty girl but has a large nose. Shes shy and self-conscious about 2 aesthetictrends.com | may june 2011
  • 3. no unexpected craniofacial mature, it is perhaps only need to wear a plastic splint on plastic surgery abnormality resulted from the the experience of the suffering their nose for a week after surgery (or the initial trauma). that allows us to better identify surgery, or a headband following Nonetheless, it is generally and handle similar stresses. an otoplasty for several weeks. considered wise to wait until after When a person feels low They will know if they want most growth has occurred before self-esteem and suffers bullying as surgery or not after hearing about performing a procedure such as a teenager over a physical the aftercare. rhinoplasty. This helps us avoid characteristic, it is logical to want Transition periods end up sticky issues with some patients as to change that aspect of the being a convenient and advisable we can simply request they wait appearance. Unfortunately, time for plastic surgery in until they are older. changing ones appearance to teenagers. These include at the The real problem here is appease a bully is unlikely to be start of summer vacation and in deciding when a teenager is successful. Worse, it can cause a particularly between school years mature enough to make an person to lose what could when they are changing from one irreversible decision. In the law, eventually be a source of pride. school to another. The ability to teens are typically emancipated at There are no clear cut enter a new place without the age 18, although not all 18-year- answers to determining when teen concerns of the old can allow a olds are emotionally mature. surgery is appropriate; however, formerly introverted young Furthermore, people are the questions posed above will person to shine. capable of bad decisions hopefully place you into the right At my office, I have throughout their lives. As in frame of mind when considering greatly enjoyed helping people much of facial plastic surgery, the how to evaluate these requests. maximize their quality of life and key is to investigate goals and Like with all plastic surgery, it has self-esteem through motivations. to be done for the patient only, improvements in their Studies have shown that and not to please a friend (or appearance. Seeing the smile on higher than 50% of young women parent!) or appease a bully. That a teenagers face when she desire to have plastic surgery of being said, there are a few recognizes her own beauty makes some type during their lives. guidelines that can help. all the efforts involved in sorting Hopefully, this trend represents a through the motivations generally increased WHEN IS THE RIGHT TIME? worthwhile. understanding, acceptance, and Correction of a congenital comfort with the science and deformity (e.g. asymmetry, cleft, services available by well trained or similar) that still remains as a aesthetic surgeons. Perhaps the About teenager can be corrected at any youth of today recognize that time that is medically advisable. the eating right, staying fit, and finding Scar revisions, keloid treatments, Author meaning in their lives are and the like can similarly be important, and that plastic surgery addressed at any time. can occasionally provide Rhinoplasty and otoplasty improvements to areas that are are two common requests in this Jeffrey H. Spiegel, M.D., is Chief of not readily corrected otherwise. age group. Once growth issues the Division of Facial Plastic and Undoubtedly, though, for some have been decided, I prefer to Reconstructive Surgery at the Boston the desire to have plastic surgery carefully discuss the nature of the Medical Center and holds academic represents a desire to change or appointments in the Departments of surgery with the patient and run from their sense of self. Peer Otolaryngology and Head and Neck explain the recovery process. Surgery and Plastic Surgery at the pressure and the pain of taunting Teen patients are very good at and bullying become magnified Boston University School of making appropriate decisions Medicine. Visit Dr. Spiegels website during the teen years. As we once they know that they will and blog: www.drspiegel.com. aesthetictrends.com | may june 2011 3