In Los Angeles, plastic surgery is everywhere. Kylie Jenner, 17, and her newly filled lips caused a big buzz not too long ago and had this mom of toddlers questioning what-the-what in the world of responsible parenting everywhere. (As I plunk this out, I'm also watching "Botched" on E! Chalk up that shameless admission to seeking added inspiration for this post.)
So I started thinking: With relentless media coverage about plastic surgery, what will I do if and when my daughters ever approach me about wanting something "done" because they see some teen doing it on TV or online? (I cringe at this thought.)
What will I do? Well, I will ask their dad because their dad happens to be a plastic surgeon. Meet my husband: He's done facial reconstructions. He's done breast reductions. He's also separated 6-month-old conjoined twins in Haiti. (True, I sometimes give him a hard time, but that's part of being a good wife.) He's not the kind of guy who will steer us wrong. (This is a guy who travels halfway across the world to do expensive surgeries for free because he thinks it's a nice thing to do for the greater good. He also swears that neither of his daughters will ever, ever date before the age of 21—or else. Yeah. We'll see how that pans out...)
So I sat him down and asked a few questions about teens and plastic surgery with hopes that something he'd say would help a parent out ... since he is a parent who happens to be a surgeon.
I decided to put things in the context of a teen wanting a rhinoplasty [nose job], because let's just say that I had major issues with my own nose when I was a youngster (my story about what I did about it may or may not be shared in the future).
Here are my questions, and here are his answers:
At what age is it appropriate for a teen to safely get a nose job?
"The safe, minimum age is 16 ... sometimes even 15 or 14, depending on the child's psychological situation, physical growth, any extreme deformities and maturity. Age 16 is generally the age when the nose stops growing, so it's considered a relative minimum age for rhinoplasty."
Are parents welcomed into the consultation process with their teen?
The teen needs to be mature enough to understand the risks and unexpected circumstances that can arise.
"Yes. Parents and/or guardians should absolutely be involved in the decision-making process so that the procedure is approached with informative discussion about benefits and risks involved. Anytime anyone undergoes anesthesia, there is a risk ... cosmetic or not. Parents and teens need to be reminded of this through an open and honest discussion with their surgeon. Every person is different and no surgeon can completely guarantee any kind of specific result—no matter how experienced they are in the field—because unexpected things can happen in surgery that may or may not affect the result of any given procedure. The teen needs to be mature enough to understand the risks and unexpected circumstances that can arise, and how those things might affect the result they might be expecting. The parents must sign approval for the surgery, but the patient must know what they're getting into ... and must be mature enough to handle it. I always encourage an open dialogue with parents and kids in the room, asking every question that they can think of."
What if a parent is absolutely against the surgery? Should the parent take the kid for a consult anyways (just to appease the kid), and inform the surgeon ahead of time?
"Yes, I would actually suggest doing this. You don't want to waste a surgeon's time, but you also want to let the surgeon know where you're coming from as a parent and get informed about options (especially if your teen is being extremely psychologically affected in a way that might affect their mental health). A lot of parents are scared of plastic surgery and the messages it sends to young people. Being open and honest with a board certified, credible surgeon is always beneficial. And, any conscious surgeon will listen to parents' concerns regarding the well being of their child."
How do you know (as a parent and surgeon) if a rhinoplasty is appropriate for a certain kid, as opposed to encouraging the kid to be happy with themselves and deal with bullies in an alternative way?
Why does the patient want the surgery? Is it because they want to look like Angelina Jolie or is it because they're getting teased at school? There's a big difference.
"An experienced surgeon should lead the parents through a series of questions discussing why the patient is seeking the procedure, what kinds of expectations they have, risks involved (bleeding, asymmetry, bumps, allergic reaction, infection), possible results, etc. One assessment that the surgeon must make is: Why does the patient want the surgery? Is it because they want to look like Angelina Jolie or is it because they're getting teased at school? There's a big difference. Parents and the surgeon must gauge what kind of psycho-social impact the teen is experiencing and navigate the consultation from there."
What are some red flags, regarding choosing a surgeon, that parents should be wary of?
"First, make sure you seek out a surgeon who is board-certified, no negotiations. It's also a smart idea to seek out surgeons who specialize in rhinoplasty (if you're seeking a rhinoplasty). Second, be careful of surgeons who might seem like they're selling you a surgery. Unfortunately, cosmetic surgery has become a business, and that reality has affected how some surgeons approach their work ... regardless if they might be dealing with teens or adults. Also, be careful of surgeons who agree too quickly to everything the parents and kid might request and/or suggest in terms of method of procedure, etc.
In other words, get informed, go with your parenting gut and don't be afraid to ask questions and offer answers ... both to your surgeon and your child."
Dr. Andre Panossian is a Board-Certified, Pediatric Plastic & Reconstructive Surgeon based in Los Angeles, Calif. He frequently volunteers for international medical missions Mending Kids International and Operation Smile. Learn more about Dr. Panossian at DrPanossian.com, or connect with him directly on Twitter or Facebook. (Dr. Panossian is married to Mom.me contributor Jill Simonian.)