10 Key Guidelines for Ethical Plastic Surgery in Teens

10 Key Guidelines for Ethical Plastic Surgery in Teens

1. Before considering any type of elective plastic surgery, it is imperative to engage the teen in a frank discussion about his or her concerns and desires. Involve the parent or guardian

2. The use of treatments to improve skin appearance from acne scarring or dermatologic problems may include chemical peels or laser therapy.

3. The use of Botox and cosmetic fillers for facial enhancements is generally and broadly discouraged in adolescents unless there is a medical reason for this type of treatment, such as a facial nerve palsy or an acquired or congenital lip or cheek deformity.

4. Elective breast augmentation should not be performed in girls younger than 18 years, and only saline implants should be used in young women from 18 up to 22 years of age. This procedure must be performed only after the patient and provider have received proper counseling.

5. Breast reduction or reshaping, and the use of breast implants for correction of significant congenital deformities or significant asymmetries, are reasonable with proper patient counseling.

6. Gynecomastia (male breast enlargement) can be treated if it does not subside in the later teenage years.
7. Otoplasty (correction of prominent ears) can and should be performed at an early age (5-7 years) if possible, when the ears are almost fully grown. At this age, the intense peer-to-peer bullying behavior has not yet begun as a result of this deformity.

8. Rhinoplasty is indicated for correction of functional or traumatic deformities as well as significant cosmetic deformities, which can lead to peer ridicule (especially in girls). It is recommended that this surgery not be done until patients reach a growth spurt lag (age 15-17 years in girls and age 17-19 years in boys).

9. Liposuction or body-contouring procedures are not indicated in most teens, because excess weight can be properly treated with diet, exercise, and nutritional counseling in most cases.

10. The most critical element to optimal outcomes, proper decision-making, and safety is to find an empathetic plastic surgeon certified by the American Board of Plastic Surgery. The plastic surgeon must have the proper expertise, judgement, and experience in the management of the complex issues in dealing with the mindset of the developing adolescent.