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Catherine Rabo always wanted a smaller nose. “It always kind of stuck out,” says the 20-year-old. Kids constantly teased her about it in elementary school. So, when she turned 19, and with her parents’ OK, she underwent a rhinoplasty that she believed would help boost her self-confidence. “I just thought, ‘I want to do this for myself,'” she said. And she couldn’t be more pleased with the results. “Since the surgery, I’m not always worrying about people staring at me because of my nose,” she says. “It’s not that I wasn’t happy before, but now I feel like myself.”

From average teens like Rabo to celebrities, young adults are flocking to plastic surgeons in hopes of nipping, tucking and enhancing their way to popularity. But is it smart to let someone so young make such a permanent decision? We asked experts Dr. Philip Solomon, facial plastic surgeon at University of Toronto and St. Michael’s Hospital, and Dr. Sammy Sliwin, plastic surgeon at the Forest Hill Institute of Aesthetic Plastic Surgery in Toronto, to explain the teen surgery phenomenon and tell us who should and shouldn’t get surgery.

Who’s doing it?

Last year, more than 200,000 cosmetic surgery procedures were performed on teens under the age of 18.

What they’re doing

Topping the list of surgical procedures are rhinoplasty, liposuction, breast reduction, correction of breast asymmetry, treatment of gynecomastia (enlarged breast tissue in teenaged boys) and chin augmentation.

Trendy non-surgical treatments include chemical peels, microdermabrasion and laser hair removal.

Why they’re doing it

The main reason teens are opting for surgery is the same reason that their parents are going under the knife – lack of self-confidence. “I think they’re probably influenced largely by the media and self-esteem issues,” says Dr. Solomon. “Self-improvement is obviously a big thing in our culture today.” The fact that surgeries have become safer, more affordable and more accepted by society is also a draw for the younger generation.

The pros

According to both Solomon and Sliwin, the benefits of getting surgery when you’re young are numerous.

Safety first When you’re young, you don’t usually have many other medical problems that may complicate surgeries in older patients.

Zit remedy Treating acne at a young age could help prevent permanent scarring.

Self-help Dealing with major self-esteem issues at a younger age, when looks are very important, could help prevent emotional scarring later on.

The cons

Feeling self-conscious is a natural part of being a teen, but a lot of these insecurities go away with time, so unless you have a real deformity, it can be tough to know whether you’re making a decision you’ll regret later on. It’s also important to remember that your body is still growing. Parts that may seem too small or too big now, may grow proportionately, looking fabulous as you age. “Operating on someone who has immature facial features can stunt regular development,” says Solomon.

Should you or shouldn’t you?

Both Sliwin and Solomon agree there’s nothing wrong with teens having plastic surgery, as long as they’re mentally stable and have an obvious cosmetic problem. In fact, conducting certain types of surgery on teens could help improve their future social and working situations. “If you can get rid of the one biggie that’s already bothering you, you may be a more stable person later on,” says Sliwin. It’s extremely important to make sure that the teen has a legitimate problem, understandable motives and realistic goals for the outcome of the surgery. A boob job, for instance, isn’t necessarily going to make a teen popular or get rid of low self-esteem.

Age gauge

“Certain surgeries, such as breast reduction, augmentation and rhinoplasty, are best conducted after you’ve reached puberty, says Solomon. That’s when a teen’s body development dramatically slows or even stops.” Solomon says his patients must be 15 before he’ll do rhinoplasty since your nose is still growing until then and better results are usually achieved after puberty.

Liposuction can also be performed on 15-year-olds, says Sliwin. That’s because the number of fat cells in your body is pretty constant at that point. He stresses, however, the importance of assessing each patient individually. Some children have genetic weight problems, while others who have lifestyle problems might better benefit from a date with a dietitian than a session with a surgeon.

For breast surgery, Sliwin requires his patients be 16. “It’s still a very difficult age,” he says. “I’m not sure these 16- or 17-year-olds are adults.” Sliwin says if teens have family support, he’ll perform the surgery when they’re 16. But if they don’t have much emotional support in their lives, he’ll wait until they’re 18.

Who’s having what

Here’s the rundown on the most popular treatments among teens under 18 in the U.S. last year, according to the American Society of Plastic Surgeons:

  • Chemical peels 995,238
  • Microdermabrasion 74,722
  • Rhinoplasty 42,515
  • Otoplasty (ear surgery) 15,973
  • Breast enlargement 3,841
  • Treatment of gynecomastia 3,033
  • Liposuction 3,017

Don’t do it

You shouldn’t have surgery if:

  • You’re being pressured by your family or friends
  • You’re prone to mood swings
  • You’re impulsive and often change your mind
  • You’re abusing drugs and/or alcohol
  • You’re being treated for depression or another mental illness

Maturity matters

Regardless of age, one of the most important things that surgeons will consider when choosing to operate on a patient is level of mental maturity, say Sliwin and Solomon. Do you want to have the surgery for valid reasons? Do you fully understand the risks involved? Do you have the same expectations as the surgeon for the procedure and the results? Does your family support your decision? If your answer to any of these questions is no, some doctors may not operate on you.

Parental advisory

What to do if your child wants surgery As a parent, it’s up to you to decide if your child should see a surgeon. Here are a few tips from Sliwin and Solomon to help you decide if your teen is ready for surgery:

Know your child “Some kids change their minds every day about what they want to be when they grow up, the music they listen to or even what movie they want to see,” says Sliwin. Make sure that their complaints (about their physical appearance) aren’t just a passing phase. Talk time Have an open discussion with your child about her insecurities, says Solomon. What are her motivations for wanting surgery? Is it because someone picked on her at school or has she always felt strongly about it? How important is it? How determined is your child to have this surgery? Does she mention it constantly? Is she willing to give up watching a month of her favourite TV show for it? Don’t judge No matter what you do, don’t be judgmental, says Solomon. If your child feels like she’s being teased or misunderstood, it could encourage her to hide her feelings from you.

How mature is your child? Maturity is a huge issue to consider before allowing your child to have surgery. Will your child be able to handle the shock of looking different? Is she aware of, and will she accept, the risks associated with surgery? Also, make sure she has realistic expectations of what her life will be like after surgery.

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