It's no surprise that many young people don't like what they see in the mirror, but a significant number now think about going under the knife in search of the perfect body.
Nearly 1 in 6 of 15- to 25-year-olds have considered breast implants, nose jobs, liposuction or other cosmetic procedures, according to a survey from global marketing agency InSites Consulting.
Each year, thousands of them go through with the procedures. Nearly 77,000 teenagers underwent elective plastic surgery last year, accounting for 5 percent of all cosmetic surgical procedures performed in 2011, according to the American Society of Plastic Surgeons (ASPS).
Rhinoplasty topped the list, with 33,892 teens attempting to reshape their noses last year.
Gynecomastia, or breast reductions for men, came in second with 14,371 procedures. At the other end, nearly 9,000 18- to 19-year-old females received breast augmentations, the third most popular surgery among teens in 2011, ASPS data show.
Often, young patients' motivation is to look like their favorite Hollywood star or to compete with peers, researchers say. But many lack the maturity to fully understand what they're signing up for or to grasp the permanent nature of a seemingly minor change to the body, said Amanda Smith, assistant director of health education programs at the University of Texas at Dallas, who specializes in helping students deal with body-image issues.
"They don't understand it. They're still at that age where it's hard to even visualize, to think long-term and project down the road," she said. "If they have the surgery that early in life, they'll never know if they would end up growing into [their features] or actually embracing them. But in this country, we're used to having quick fixes for our problems. Everything is at our fingertips, and pretty much everything you want, you can have instantly."
Plastic surgeons typically exercise caution when deciding whether to accept teenage patients, and the screening process usually involves lengthy consultations to determine exactly why they want the procedures.
Most medical professionals are willing to say no when necessary, said Dr. Michael Olding, chief of plastic surgery at George Washington University's School of Medicine.
"There are certainly significant differences when approaching anyone under the age of 18. We hesitate to operate on them unless there's a compelling reason to do so," he said.
"At the age of 18, they're adults, but younger than that, they're often emotionally immature and physically immature. I want to speak to the child and hear about their motivations, and hear that they're the ones initiating the requests, not the parents. And I want to see if the request is a logical one," Dr. Olding said.
A teenage girl in need of a breast reduction, Dr. Olding said, is often justified. Breasts that are too large can cause long-term back and shoulder problems. Girls of the same age group seeking breast augmentations in a bid to look sexier may not be justified.
The desire to change one's physical appearance is often rooted deep beneath the skin, Ms. Smith said. Being teased or bullied by classmates can cause a young person's self-esteem to plummet, particularly if they're picked on because of a physical feature.
Undergoing plastic surgery to change that feature may help in the short term, but could lead to bigger problems down the road, specialists say.
"Their real issue isn't being treated. The real issue is psychological, and surgery is never going to fix that," Ms. Smith said. "If parents would take the time to help them work through their emotional issues, they would have the opportunity to become a lot more comfortable in their own bodies."
While Hollywood may be contributing to young Americans' desire to improve their bodies, some film stars have begun to send a different message to teens by rebelling against plastic surgery.
Actresses Kate Winslet, Rachel Weisz and others have come out against cosmetic procedures over the past year. The two Oscar-winning women have vowed never to go under the knife, even though the 36-year-old Miss Winslet and the 42-year-old Miss Weisz are approaching the age when leading roles for women start to dry up. For decades, actresses have resorted to plastic surgery to continue to look young.
Cosmetic surgery "goes against my morals, the way that my parents brought me up and what I consider to be natural beauty," Miss Winslet told the Daily Telegraph in an interview last year.
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