Cutting into childhood - the disturbing growth of teenage cosmetic surgery

Posted: 11/09/2014


As cosmetic surgery becomes more accepted as 'normal' in today's society, more teenagers are going under the knife in a bid to enhance their natural appearance and cope with the pressure to look good.

In this article, the Penningtons Manches’ specialist cosmetic surgery team takes a look behind the statistics of this disturbing trend.

Nearly a decade ago, a survey by Bliss magazine, whose average reader age is 14, found that 40% of teenagers had considered having plastic surgery. In April 2013, a report by NHS medical director, Sir Bruce Keogh, found that 41% of girls aged seven to 10 and 63% of 11 to 16 year olds said they felt some pressure to look like celebrities.

In a recent article in Reveal.co.uk, a 25 year old woman who has already spent £25,000 on numerous cosmetic surgery was only six years old when she had her ears pinned back. After seeing the results, she said: "I got a taste for altering my body. I didn't see why you had to accept the way you looked when there were so many treatments and surgeries available to tweak every part of you." She intends to have further work done in the future to maintain her looks: "When I'm older, I'll have Botox. Why not? A nip here, a tuck there, I don't see what the big deal is."

The cutting facts

The American Society of Plastic Surgeons (ASPS) holds the most current plastic surgery statistics on teenagers:

  • 236,356 cosmetic plastic surgery procedures were performed on 13-19 year olds in 2012.
  • Almost half of all cosmetic surgical procedures performed on teenagers are rhinoplasty (nose reshaping) procedures.
  • The surgical correction of protruding ears (otoplasty) accounts for 11% of all plastic surgical procedures performed on teenagers.
  • More than 8,500 breast augmentations were performed on 18-19 year olds in 2010, up 3% from 2009.
  • In 2010, around 9,100 microdermabrasion procedures, 19,500 laser skin resurfacing procedures, 5,500 chemical peels and 3,000 dermabrasions were performed on teenagers aged between 13 and 19.
  • 13,500 gynecomastia (male breast reduction) procedures were performed on boys aged 13-19 in 2010 (17% of cosmetic surgical procedures).

The expert view

Mr Nick Parkhouse, consultant plastic surgeon, explained on the BBC that there are "a small number of teenagers for whom plastic surgery would be appropriate. For instance, operations to correct cleft palates or prominent ears would bring benefit."  But he also said that "plastic surgery was inappropriate for the vast majority of teenagers. Plastic surgery carries a risk of complications, side effects such as scarring, and the risk of disappointment with the results. All these things need to be taken very carefully into account. Cosmetic surgery to correct disfigurement should not be discounted but the idea of using it as a cosmetic social enhancement such as ear piercing is inappropriate."

Increase in extreme procedures

Recent reports suggest that younger people suffering from Body Dysmorphic Disorder (BDD) are increasingly turning to more extreme cosmetic surgery procedures. For example, in 2013, the Royal College of Obstetricians and Gynaecologists (RCOG) suggested restrictions on labiaplasty (labia trimming and reduction) procedures due to concerns about the increasing number of teenage girls having the operation for cosmetic reasons.

People with BDD are often uncomfortable with and critical of their physical appearance, despite having no obvious imperfections. In many situations, those who have surgery with this disorder make their condition worse. Following the correction of one imagined defect, BDD sufferers quickly become fixated with another imagined defect and the cycle continues.

From both our experience and media comment, the number of people  - particularly young BDD sufferers - who either have complications or are disappointed with the results of their cosmetic surgery and subsequently develop psychological problems is increasing.

Psychological assessments needed for young patients

The current debate is whether people who elect to undergo cosmetic surgery procedures should be psychologically assessed pre-operatively to determine whether surgery will benefit them or put them at risk of psychological harm.  This is especially important for younger patients.

When an 18 year old requests a blepharoplasty (eyelid surgery) or a very slim person asks for liposuction, should surgeons be asking themselves: “Why is this person asking for an “improvement” and how do they expect the “improvement” to affect them day to day?” In cases where it is objectively difficult to see the need for a procedure but the patient appears to be attaching great importance to it, should a mandatory referral be made for psychological assessment?

A psychological assessment may help some patients to understand that surgery is unlikely to have a positive outcome and a proper exploration of someone’s motivations for wanting surgery could avoid some post-operative problems.

Surgery will not always improve self-esteem

Amy Milner and Sarah Gubbins, clinical negligence lawyers at Penningtons Manches LLP, comment: "Our concern is that girls and young women are opting for surgery before they are physically or emotionally mature. They are not considering the associated complications and risks, the long term physical effects, the psychological implications, and the likelihood that surgery may not resolve their underlying social or confidence issues.

“A psychological assessment is particularly important for teenagers to ensure that they are mature enough to make such life-changing decisions. When young girls seek to change themselves beyond recognition to look like Barbie or their favourite celebrity, surgeons need to question their motivations and make them fully aware of what can go wrong, rather than simply focusing on the digitally enhanced results they see in the celebrity magazines.  

“We are receiving more enquiries from people with pre-existing psychological problems which cannot be resolved by undergoing cosmetic procedures. More often than not, their condition worsens and their self-esteem is further eroded. Given the increasingly high rates of cosmetic surgery, any clinic offering cosmetic surgery should thoroughly explore a young patient’s medical history - particularly if the procedure being requested is unusual and it is not immediately obvious why it is needed.

“If a consultation with a psychologist prior to any cosmetic procedure is neither available nor appropriate, surgeons must do a thorough assessment of the patient’s history and their reasons for wanting surgery and be very clear on what can and cannot be achieved by the proposed procedure.”

Penningtons Manches LLP has a leading clinical negligence practice that deals with clients nationwide.  Within that practice, we have a specialist team dealing with cosmetic surgery claims relating to treatment performed in the UK and abroad.  Members of the team can advise on issues arising from such treatment and the options in relation to any claim.


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