Teens Choosing to Go Under the Knife

In a review focused on two cosmetic procedures — liposuction and breast augmentation — that have become markedly more popular among adolescent females during the past decade, the authors emphasized physical and psychiatric reasons to delay such procedures past the teenage years. Weight gain, common during late adolescence and young adulthood, can dampen the desire for breast augmentation and also undo the outcomes of early liposuction. Moreover, body image often changes with maturation, lessening the desire for “correction” of perceived imperfections.

Body dysmorphic disorder (BDD) — “a preoccupation with an imagined or slight defect in appearance that leads to significant impairment in functioning” — typically does not improve and can worsen as a result of cosmetic surgery. The average age at diagnosis of BDD is 16, and the authors suggest that teens who request cosmetic surgery be screened for this condition with a questionnaire. Although research indicates that the popular perception of cosmetic surgery exaggerates its benefits and minimizes its risks, no evidence-based literature or research has revealed any mental health benefits of plastic surgery in teenagers.

The FDA has approved saline breast implants for adult women aged 18 or older and silicone implants for women aged 22 or older; however, off-label use for younger patients is legal. Implants can have long-term negative health implications, the likelihood of which rises with time. Implant lifespan is about 10 years, and approximately one third of augmentation patients undergo additional surgery within 3 years. Thus, adolescents who undergo augmentation probably will require repeat surgeries, possibly at a time when they might not have the financial resources to pay for procedures that are not covered by insurance.