A little lift here, a little tuck there—plastic surgery has long since been normal, even outside of Hollywood. Teens and plastic surgery, though, is a topic that isn’t as common. Some teens want breast implants or reductions, nose jobs, even tummy tucks. Their concerns aren’t always cosmetic, though; some local teens sought out plastic surgery for medical reasons.
It would be an understatement to say Alex loved lacrosse; the Montgomery County teenager played it since the third grade. She had a passion for the game — and her four broken noses were a testimony to her dedication. After turning 18 last July, with high school and her lacrosse-playing days behind her, Alex decided to fix her broken nose with rhinoplasty. She sought the help of cosmetic surgeon Dr. Michael Will, of Will Surgical Arts in Urbana, Maryland. Dr. Will is board-certified in cosmetic surgery, oral surgery [he has a DDS in addition to an MD], and dental anesthesiology.

During initial consultations with young patients, Dr. Will often advises them to hold off on surgery. “Many teens think [cosmetic surgery] is an easy fix. They want immediate gratification,” Dr. Will says.

For example, Alex “had to wait until I was 18 and done playing sports,” she says

Alex’s rhinoplasty corrected her deviated septum. Once the surgery got underway, the damage was found to be more extensive than anyone thought. Her breathing had been slightly compromised on the right side of her nose, and she says her breathing has since improved substantially.  She says it was a great success, and feels it restored her nose to way it looked before the breaks, “but most people can’t tell the difference. I think it looks the way it was when I was a freshman.”

As for the recovery process, Alex says it was painless. “I had two black eyes, and was swollen for awhile, but there was no scar.” The recovery took about 3 weeks, and the area around her nose was tender for about 2-3 months.

For young adults and their families who are considering plastic surgery, whether it’s rhinoplasty, otoplasty [the pinning back of ears], or even reduction mammaplasty (breast reduction), it’s essential to find a physician experienced in working with teens, and one who takes the time to put these patients at ease.  Dr. Will spends more time with his young patients, like Alex. “While I see adult patients at least twice before surgery, I frequently see teenagers three times or more  to get at the root of what they're looking for from the procedure.”

He will talk at length with the teen to try to get to the heart of her concerns, and find out the why he or she wants surgery. “You have to look into the psychological issues behind the request for cosmetic surgery. Often social or peer pressure is behind some requests. I ask them why they’re doing it. I want them to tell me it bothers them every day, and that they’ve tried  non-surgical options first.”
Dr. Alan Gold, president of the American Society of Aesthetic Plastic Surgery (ASAPS), with a practice in Great Neck, New York, counsels parents and teen patients together, but does the physical exam separately. He looks for emotional maturity, and makes sure his young patients understand the short-term consequences of their decision – the bruising, discomfort, time out of school and away from their social lives. When it comes to cosmetic surgery, Dr. Gold says “too many teens are influenced by TV and expect the surgery to do something it can’t.”

These expectations are often driven by watching reality television shows such as “Extreme Makeover,” “The Swan,” and MTV’s “I Want a Famous Face.” In a small study published in the July 2007 issue of the Journal of Plastic and Reconstructive Surgery, published by the American Society of Plastic Surgeons (ASPS), researchers studied 42 cosmetic surgery patients, and four out of five of these patients “reported television directly influenced them to pursue a cosmetic plastic surgery procedure.” According to the ASPS, the number of teenagers seeking cosmetic surgery is on the rise.

If a teenager asks her mother for cosmetic surgery for her 16th birthday, Dr. Gold believes, parents shouldn’t immediately be dismissive of the idea. Use the request as an opportunity to listen, and hear what’s really bothering your child.

For a family considering plastic surgery, take the time to interview several cosmetic surgeons until you find one with whom everyone is comfortable. Ask questions, look at their Before and After photographs, and ask how often they have done the procedure on young adults.  Look for board certification in plastic surgery. Be sure to include your family doctor or pediatrician, or some other trusted healthcare provider, in the decision process.

Several plastic surgeons are opposed to doing procedures on teenagers that they view as “sexualizing.” According to Rockville- and Fairfax-based cosmetic surgeon and laser expert, Dr. Hema Sundaram, “both as a doctor and as the mom of a teenage daughter, I'm very aware of the importance of allowing teens to still be the children they truly are, especially with the increasing societal pressure on teens to grow up too much too soon. Procedures that I consider inappropriate for those under 18 include liposuction (because a teen's body has not yet found its metabolic set point), lip and breast augmentation and Brazilian style bikini area laser hair removal.”

Many teenage girls are self-conscious when it comes to the size of their breasts.  In this respect Jane* of Montgomery County was no different. However, she wore a 34DDD bra, and almost all athletic pursuits, especially her favorite —running — was more difficult and painful due to her large breasts.

Dr. Michael Cohen, medical director of the Cosmetic Surgery Center of Maryland in Towson was the fourth doctor that Jane and her mom consulted. Both say they knew within seconds of meeting him that he was the right choice. She says he was very supportive, and concerned with making her feel comfortable. Last summer at age 17 she had breast reduction surgery, and is now a 34C.

Recovery consisted of “bed rest for about two weeks, no workouts for one month, and I couldn’t wear a bra with underwire for at least two months,” she says. “I really wasn’t in much discomfort. The hardest part was not being able to sleep on my stomach. My chest was super sensitive.”

For Jane, the surgery transformed not only her chest, but her general outlook on life. She is more upbeat and happier, and attributes her increased self-confidence and motivation to the surgery.  “I wanted to do it for a long time. I had to wear looser, baggy clothing on top, and I had to wear three bras when I worked out. I was so off balance when I played lacrosse, it affected back and my alignment. Surgery was hard, but it was much harder before the surgery. Dr. Cohen was so positive … other doctors were discouraging,” says Jane.

While always supportive of her daughter, Jane’s mom didn’t see the need for surgery as urgently as Jane. In addition to several plastic surgeons she took Jane to see her family doctor, her pediatrician, and to a gynecologist. “I wanted everyone’s input. We exhausted all avenues.”
“I would completely recommend it. I was scared, but I feel so much better. This was one of the best decisions I’ve ever made,” says Jane.

*Her name was changed to protect her privacy.

By Deeanna Franklin Campbell

Chesapeake Family serves parents and families in Annapolis, Anne Arundel County, Baltimore, Bowie, Calvert and Prince George’s County and the Eastern Shore of Maryland.