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| THE AGE DEBATE | ANALYSIS On examining her, the surgeons


decided to also carry out mento- and rhinoplasty during the same operating procedure, which cost $40 000 in total. While bullying at school is sadly not


uncommon, undertaking cosmetic plastic surgery to avoid it is. This recent US episode, however, threw the doors open once again on the debate over whether aesthetic plastic surgery is ever justified in those under, say, 16 or 18 years of age.


Otoplasty a major procedure in the US The American Society of Aesthetic Plastic Surgeons (ASAPS) noted in 2010 that otoplasty is the most popular surgical procedure for US teens. Such surgery is often recommended for children as they near total ear development, at the age 5 or 6 years — prior to the child entering school — which may obviate potential teasing from classmates. The next most common procedure,


says ASAPS, is rhinoplasty (the most requested aesthetic surgical procedure by teens), which can be performed in girls aged 13–14 years and boys aged 15–16 years (i.e. when the nose is 90% grown). Thereafter come breast reduction,


usually delayed until the breasts have reached full development; corrective breast asymmetry surgery (US federal regulations prohibit breast implants for under 18s, except in cases of asymmetry and postoperative reconstruction); and treatment of gynaecomastia for teenage boys. Almost 219 000 cosmetic plastic surgery procedures


(including


non-invasive procedures) were performed on US 13–19-year-olds in 2010. US health insurance does not pay for


cosmetic plastic surgery, but coverage is often provided when a procedure alleviates physical symptoms or improves a body function (e.g. breast reduction to eliminate severe back and neck pain).


Parent the crucial link The dilemma for surgeons and patients (and their parents) is summed up by ASAPS’ fellow lobby group the American Society of Plastic Surgeons (ASPS). In a statement, it says that while it has no formal position on plastic surgery for teenagers, it does not fundamentally dissuade potential patients. Under 18-year-olds require parental consent, but ASPS advises parents to evaluate the


Almost 219 000


cosmetic plastic surgery procedures were performed on US 13–19-year-olds in 2010.


teenager's physical and emotional maturity as a pre-condition. Certain cases call for guidance by an Board of Plastic


American


Surgery-certified plastic surgeon. And certain milestones in growth and physical maturity must be achieved before undergoing plastic surgery. The parent is the crucial link, as a public


survey run in Seattle this summer showed. RealSelf.com, an online cosmetic surgeries and treatments community, asked the public’s opinions about teen plastic surgery. It found that 68% of people were in favour of plastic surgery for teens when it comes to bullying; 24% identified rhinoplasty and otoplasty as appropriate,


if it averted possible bullying. RealSelf values the medical–beauty


industry (elective cosmetic surgery, obesity management and cosmetic dentistry) at $30 billion.


The US market for teen surgery ASPS says that the most common surgery procedures for teens are: ■ Rhinoplasty ordinarily not performed until the nose reaches its adult size (age 15–16 years in girls; 16–17 years in boys). ASPS says that 35 000 rhinoplasty procedures were performed on patients aged 13– 19 years in 2010. This was almost 50% of all cosmetic surgical procedures performed on this age group


■ Otoplasty made up 11% of cosmetic surgical procedures performed on this age group in 2010 (8700 procedures), but also 42% of this surgery (all ages) across the US


■ Breast asymmetry surgery prime-journal.com | November/December 2012 ❚ 15


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