IS YOUR TEEN CONSIDERING PLASTIC SURGERY? HERE'S HOW TO TALK ABOUT IT

As a plastic surgeon, I see young women come into my office for all sorts of reasons - most often, they're curious about or seeking a breast reduction, breast augmentation, and chin liposuction. While this might shock some, the truth is we've all experienced having things about our bodies that we don't like. It's practically a rite of passage for adolescence. I'm not sure I know anyone who hasn't had braces or Invisalign to straighten their teeth, for example.

But now, teens and young adults are seeking more invasive treatments - high-grade skin-care products, laser treatments, lip fillers, and even plastic surgery - which can understandably cause a dilemma for parents. It's well-known that body image concerns are often ubiquitous during puberty, and can have a negative impact on mental health. Exposure to social media, celebrity influence, and the use of filters on images have led to more young adults chasing (often unrealistic) beauty standards, and they've also gained a greater awareness of cosmetic procedures to help them achieve their goals.

While there are some young men undergoing cosmetic plastic surgery procedures, the majority of such patients are young women. According to the American Society of Plastic Surgeons 2023 Plastic Surgery Statistics, the top five most common surgical procedures for patients ages 18-19 were breast reduction, rhinoplasty (nose jobs), liposuction, gynecomastia surgery (male breast reduction), and breast augmentation.

When they come to my office, young women have varying degrees of knowledge about the procedures for which they are seeking consultation. Some arrive at the decision to see me for a consultation after doing research about something that bothers them. Others become aware of procedures through celebrities and influencers sharing their experiences or from other social media content. And then there are those who seek a consultation at the suggestion of their mothers and know very little prior to the consultation.

No matter how a young woman reaches a plastic surgery consultation appointment, I think that it is helpful for her to bring a parent, a friend, or someone who will help take care of her after surgery to that initial office visit. Just as most of these adolescent patients are young women, the parent who is most often included in these discussions is the mom, especially because a lot of these young women are contemplating breast surgery.

In my practice specifically, I meet with many moms - including those who have had cosmetic surgery themselves - who are increasingly confronted with navigating these conversations with their daughters. Often, they are trying to promote self-acceptance while also supporting their daughters' decisions to surgically address something that bothers them. Given that I see these discussions play out all the time, here are the issues I encourage moms to consider when having these conversations with their daughters.

Take Age and Emotional Maturity Into Account

During adolescence, young adults are experiencing growth spurts and significant changes in their bodies. It usually doesn't make sense to have elective surgery to a part of the body that is still in transition. However, I do think that it is reasonable for moms to entertain discussions with their daughters at this time about the changes these young women are experiencing in their bodies and any aspects of their bodies with which they are unhappy. It may also be helpful to engage in these discussions with a pediatrician, gynecologist, or plastic surgeon. If the daughter seems distressed about her body in a way that is out of proportion to what would be considered the norm, having a conversation with a mental health professional is helpful.

When young adults are considering surgery, it's also an opportunity to teach them about bodily autonomy and being advocates for their health. This is a marked departure from the child being dragged to the doctor's office by a parent and not being involved in any of the discussions or decision-making. Some things for parents to consider when assessing their teen's emotional maturity include self-awareness; impulse control; mechanisms for coping with change, stress, disappointment, and challenges; ability to set realistic goals and develop plans to work toward them; and accountability.

A young adult who is not yet emotionally mature enough to participate in his or her healthcare and who is unable to cope with the changes that occur when healing from surgery is, in my opinion, not emotionally mature enough to undergo an elective cosmetic procedure.

Understand Risks, Potential Complications, and Long-Term Implications

For any young woman undergoing a procedure, she has to consider if the benefits of the procedure outweigh the potential complications. She also needs to understand her unique risk of complications, which varies with factors such as underlying health conditions and anatomy.

When I see young women in consultation for breast reduction, for example, we discuss the implications of having a breast reduction prior to a pregnancy, including the potential impact of the surgery on future breastfeeding and how the breasts can change with the weight changes that occur with pregnancy. Having a breast reduction prior to pregnancy often means having another breast surgery (a breast reduction or a breast lift) to address the changes in the breast after the pregnancy-related breast changes.

I routinely tell young women that there is no right or wrong choice, but only they can decide what's most important to them. They can address their breast issues (back pain, difficulty finding bras and clothes that fit properly, body insecurities) prior to a pregnancy and potentially have to undergo another breast surgery in the future, or they can wait until after pregnancy to have the breast reduction and minimize their chance of needing another breast surgery.

Consider Reversibility and Alternatives

As someone who was a precocious teen, I was always very confident that I knew what I wanted. Time often revealed that I was wrong. I now advise moms to encourage their daughters to take baby steps and start out with less invasive and less permanent treatments before jumping into surgery, when applicable. For example, depending on what bothers a young woman about her nose, a liquid rhinoplasty with filler may be able to give her an idea of what her nose would look like before undergoing a surgical rhinoplasty.

In my experience, moms in particular seem more open to supporting their daughters' choices with regards to procedures that can be reversed. Lip fillers are a great example of that. Celebrity influencers have been increasingly getting lip fillers, which has in recent years sparked much interest among young women. Given that the filler can be dissolved, many moms have been more comfortable with their daughters moving forward with that.

Use This as an Opportunity For Important Conversations

Another important aspect of these discussions is the cost of the procedure and who is going to pay for it. I routinely see procedures being "gifted" as birthday or graduation presents, but paying for a procedure herself could make a young woman more engaged and literally invested in the decision and process.

I also think these conversations can be a bonding experience and moment of transparency for moms to share with their daughters the body insecurities that they have had and what they have or have not done to address them - including acceptance, therapy, and surgery - and what they are glad or regret they did.

As women, we should acknowledge the stress that many of us have around body ideals and normalize having transparent discussions about not only how we feel but what we're doing to address how we feel. During these discussions, it is extremely important to ensure that both parties feel heard and respected and that there is a genuine effort to understand each other's perspective. By thoughtfully considering these things together, moms and daughters can forge a stronger bond and build community with other women who share these experiences.

Aisha White, MD, is a board-certified plastic surgeon in Austin, TX. She is passionate about educating girls and women about their bodies and healthcare choices and bodily autonomy; promoting and supporting diversity in the beauty industry (including ethnic diversity, size inclusivity, and age inclusivity); and advancing awareness and facilitating conversations around the intersection of mental health issues, unrealistic beauty standards, and plastic surgery. Dr. White has appeared in numerous scientific journals and is published for her research and work related to reconstructive plastic surgery.

2024-06-27T13:50:08Z dg43tfdfdgfd