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Taken from http://today.msnbc.msn.com/id/36101073/ns/today-parenting_and_family (published 3/30/2010)

Experts mull Pros and Cons of letting youths go under knife

by Laura T. Coffey

Teens can be mean. Just ask Jen Selter, Jon Escalante and Hannah Olson.

For years, Selter endured taunts because of her nose size. Kids ridiculed her by saying she looked like a pelican and by calling her “butter face” — code for “She’s hot, but her face!”

Escalante deliberately grew his hair out to hide ears that had branded him with the nickname “Dumbo.” And Olson’s self-confidence flagged as she tolerated “horrifying” name-calling after developing DDD-size breasts as a teen.

In a world where people of all ages increasingly turn to plastic surgery for reasons that are purely cosmetic — and, in some cases, narcissistic — Selter, Escalante and Olson said they opted to go under the knife as teenagers for different reasons. It wasn’t something they did solely because of the relentless name-calling. It also had a whole lot to do with how they felt about themselves on a deeper level.

“My advice to teenagers is don’t have a nose job just ‘cause you’re worried about what other people say or think,” said Selter, who had rhinoplasty done last summer at age 15. “It all has to do with how you feel on the inside. And getting a nose job made me feel good inside and out.”

TODAY Once Jon Escalante had his ears surgically pinned back, he felt confident enough to cut his hair in order to pursue his dream of becoming a firefighter.

Like ‘braces for crooked teeth’?
To be sure, the very notion of doing any kind of plastic surgery on teenagers raises concerns for many parents and health professionals — and there are valid reasons for concern.

“Mom and Dad, please be sure your adolescent or your teen is aware that this is not a coping skill — that every time we feel uncomfortable about ourselves, then we go out and we get surgery,” psychiatrist Charles Sophy told TODAY. “Because that’s how we begin a huge line of problems.”

Reputable cosmetic surgeons with teen patients typically recommend a series of at least four sessions with a therapist before moving forward with any procedures. The point of these sessions is to uncover underlying motives for wanting surgery, as well as to determine the emotional maturity of the patient.

Such precautionary steps are important because demand is on the rise. Although just two percent of all plastic surgeries are performed on teens, the number of teens getting plastic surgery has doubled since 2002, according to the American Society of Plastic Surgeons. Nose reshaping, ear reshaping, acne and acne-scar treatment, breast augmentation and breast reduction are popular procedures among teenage patients.

TODAY Hannah Olson’s breast-reduction surgery gave her relief from pain and made it possible to maintain an active, athletic lifestyle.

Generally speaking, plastic surgeons report that many teens want plastic surgery because they long to fit in with their friends, while many adults pursue plastic surgery because they want to stand out.

But when a teen seeks out plastic surgery to correct a noticeable physical defect or to change a body part that’s caused prolonged psychological distress, that can be a good thing, doctors say.

“It’s no different than kids getting braces for crooked teeth,” said Dr. Sam Rizk, Selter’splasticsurgeon.

Dr. Nancy Snyderman, NBC’s chief medical editor, agreed that plastic surgery can be altogether positive in the right circumstances. In the cases of Selter, Escalante and Olson — all of whom were featured in Friday’s edition of People magazine and interviewed on TODAY on Tuesday — Snyderman thought they made responsible choices when they decided to have plastic surgery done at ages 15, 17 and 19.

“Remember we’re not looking at 10- and 11-year-olds,” Snyderman said. “We’re looking at young adults who were part of the decision-making process, and that plays a big role. … You’re looking at three very appropriate cases for wanting to change things.”

TODAY Jen Selter’s nose job at age 15 made her a more confident and carefree teen.

How young is too young?
Before moving ahead with any kind of plastic surgery, parents and teens are encouraged to remember that surgeries are never risk-free. They should read up about any possible complications and be sure they can handle the risks involved. A real awareness of the risks can prompt parents and children to pursue non-surgical options for changing body image, such as diet and exercise.

Parents and children also should be aware that guidelines do exist for younger patients. Facial plastic surgery generally should not be done on anyone until facial growth is complete. For a female, that happens by about age 14; for a male, it’s about age 15.

The U.S.Foodand Drug Administration will not allow breast augmentation to be done on anyone younger than 18, and most surgeons will refuse to perform liposuction on anyone younger than 17 or 18.

(Generally speaking, it can be wise to choose a surgeon who has experience working with younger patients. Be sure to check the surgeon’s complaint history.)

For their parts, Escalante, Olson and Selter all told TODAY that they have no regrets about their plastic surgeries. Escalante’s decision to have his ears pinned back made him feel good about cutting his hair to pursue his dream of becoming a firefighter. Olson’s breast-reduction surgery gave her relief from pain and made it possible to maintain an active, athletic lifestyle. And Selter’s nose job made her more confident and carefree.

“Jen is so happy now,” said Selter’s mother, Jill Weinstein. “I would say to parents … it’s the greatest gift you could give to your child. What greater gift is confidence and to help them feel happy in who they are?”

Who is a candidate for breast reduction?

Women with large, disproportionate breasts with pain, discomfort or embarrassment due to their breast size may be good candidates for breast reduction  (reduction mammaplasty). Ideal candidates for a breast reduction are women who are not pregnant or breastfeeding, are done having children, and are at a stable weight. Although breast reduction is generally recommended for mature women with fully developed breasts, surgery may be performed on younger women if their breasts are causing serious pain and physical discomfort.

When can patients return to work and resume normal daily activities?

After breast reduction surgery, it is often possible to return to work within one to two weeks, depending on the patient’s job.  Many patients resume most of their normal activities, including some form of mild exercise, within a few weeks. You may continue to experience some mild, periodic discomfort during this time, but these feelings are normal.

Because sexual arousal could cause incisions to swell and create the possibility of delayed healing, sexual activity should be avoided for at least two weeks after breast reduction surgery.

When can patients shower after breast reduction surgery?

Patients are often concerned that limited mobility after surgery will prevent them from showering for several days.  Dr. Jejurikar recommends that patients shower as soon as their drains are removed after surgery, generally about 48-72 hours postoperatively, to help them feel refreshed and to keep their breast skin clean.

Will health insurance cover the breast reduction procedure?

Breast reductions may be covered by medical insurance if the purpose of the breast reduction surgery is to alleviate physical discomfort and pain caused by oversized breasts. Many factors determine your eligibility, including the specific terms of your insurance policy and the amount of breast tissue to be removed.

Insurance companies require specific documentation from plastic surgeons prior to approving reduction mammaplasty.  This usually includes photographs demonstrating large breasts and shoulder grooving from bra straps, as well as a letter describing patient’s symptoms, other treatment modalities attempted, and the estimated amount of tissue that will be removed.

Supporting documentation from other physicians and health care professionals can be very helpful in facilitating the approval process.  Letters from physical therapists and chiropractors documenting failed therapy for back pain and neck pain, as well as from primary care doctors demonstrating neck pain, shoulder pain and heat rashes despite appropriate use of a support bra, all help immensely.

How long will the results of breast reduction surgery last?

After breast reduction surgery, provided patients do not gain or lose a significant amount of weight or become pregnant, breast size should remain relatively constant in size. However, the effects of aging and gravity cause all tissues to sag over time; the breasts are no exception. If, after a period of years, the breasts become saggy or droopy, patients may choose to undergo a breast lift procedure to restore a more youthful contour.

Will there be scarring?

The various techniques for breast reductions require different incisions. Traditional breast reduction surgery uses anchor-like incisions that extend around the nipple, down the middle of the breast, and at the crease at the base of the breast. Vertical incision (lollipop) breast reduction surgery creates shorter scars that also circle the nipple and extend vertically down the breast, but avoid making an incision at the crease below the breast.   Dr. Jejurikar designs his incisions with the goal of minimizing scars while still creating an aesthetically pleasing breast. Scars from breast reductions tend to fade over time and can be hidden under bras, bathing suits, or a low cut top.

Can I breastfeed after a breast reduction?

There is a significant chance that breastfeeding is not be possible after breast reduction.   It is not possible to predict with certainty who will be able to breast feed after breast reduction surgery. Thus, if this is of paramount importance to a patient, she should delay surgery until a later time.

What are the risks and complications of breast reduction surgery?

Breast reduction surgery may have potential complications that are possible for all surgeries, including bleeding, infection, hematoma, adverse reactions to anesthesia, and poor scarring.  Potential risks that are specific to breast reduction surgery include asymmetrical breasts, altered or loss of nipple and areola sensitivity, and the inability to breastfeed.

The numbers of women presenting to Dallas Plastic Surgery Institute complaining of sagging, droopy and deflated breasts, not to mention bulging tummys with extra fat and skin, continue to climb.  Very few of these women ask for a mommy makeover, but they all share one common goal: to restore their pre-baby body!

Mommy makeovers, or post-maternity breast and body reshaping, are individualized for every patient, but can include tummy tuck (abdominoplasty), breast augmentation, breast lift, breast lift with breast implants, breast reduction, and liposuction.  No two patients are the same, so the specifics of the mommy makeover vary from patient-to-patient.

Through the end of April, enjoy 10% off surgeon’s fees for all mommy makeover procedures.  Call 214.827.2814 to schedule a consultation today!

Many patients have asked me if they can smoke cigarettes up to the time of their cosmetic surgery.  The procedures most often in question are breast lifts with or without implants, breast reductions, tummy tucks and facelifts.  Simply put, smoking and these procedures can be recipes for disaster.  I strongly encourage smokers to quit smoking before these surgeries, as tobacco, nicotine, and carbon monoxide, all of which are within cigarettes, can impede wound healing.  In operations which involve lifting and tightening large amounts of skin, this can result in skin separation, or worse yet, skin loss.

Most board-certified plastic surgeons are selective in the procedures that they will offer to tobacco users.  Some procedures that do not require a significant amount of skin lifting, such as rhinoplasty, liposuction and breast augmentation, are thought to be somewhat safer to perform in smokers than procedures that require more skin manipulation.  For that reason, most plastic surgeons will perform these surgeries in smokers, but will still extend significant disclaimers and warnings.

Virtually everyone knows that smoking can cause pulmonary problems, heart disease and lung cancer.  For those reasons alone, I encourage all patients to quit using tobacco products.  In regards to cosmetic surgery, tobacco usage can cause significant problems with healing.  Because cosmetic surgery is elective, it only makes sense to quit tobacco usage prior to surgery to minimize this potential risk.

This is taken directly from a press release from the American Society for Aesthetic Plastic Surgery

New York, NY and Arlington Heights, IL – What people find beautiful about themselves may be different than what they find appealing in another person. That’s just one finding from a recent consumer survey conducted on the BeautyforLife website (a joint venture of the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery.) Visitors were asked “What aspect of physical beauty do you find most appealing in another person?” In their 20s, 30s, and 40s, respondents look for a fit, well proportioned body; youthful skin ranked at the top for respondents in the 50s and 60s. When considering “Which part of your body are you most concerned about?” respondents ranked their abdomen/hips number one in their 30s. But surprisingly, respondents listed the face, not their body, as the most popular choice in the 20s, 40s, 50s and 60s.

“It is always important to understand what our patients are most concerned about at different stages of their lives. We want to be equipped to help our patients make the right decisions to maintain their beauty at every age—no matter which type of cosmetic medical procedure they are interested in.” said ASAPS President Renato Saltz, MD.

Additional results were revealed when answering “Which part of your body are you most concerned about?” While respondents primarily chose their face, significantly more respondents are concerned about their abdomen/hips than their breasts (chest)—with the disparity increasing throughout the decades:

1. 30s - 37% chose abdomen/hips as their top concern while only 18% chose breasts
2. 40s - 32% selected abdomen/hips and only 10% breast
3. 50s - 25% chose abdomen/hips compared to 7% breast
4. 60s - 23% indicated concern about their abdomen/hips, while only 7% selected breast

Community members were also asked to consider “The most important reason to maintain your physical appearance.” “To boost self-confidence” was the top choice across all decades, with “To attract potential partners” a close second for the 20s. In the 30s and 40s, the second-most popular choice shifted to “To increase professional opportunities,” which remained the number two choice in the 50s, but by a much smaller percentage. In the 60s, increasing professional opportunities fell to third behind “To help make friends.”

“The survey on the BeautyforLife website has provided interesting data about patients’ attitudes, motivation and perception. Our goal is to provide useful tools for prospective patients to help them first decide if a cosmetic medicine procedure is right for them and then to provide information on how to choose an appropriate provider,” said Dr. Richard D’Amico, past president of ASPS.

Another question asked members to contemplate “The most important factor in maintaining beauty.” While adherence to a healthy diet, regular exercise and skin care were popular choices, approximately one in five members felt that a cosmetic medical procedure was most important in the 50s and 60s.

This survey was conducted by The American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, via their Beauty for Life program—a series of patient education tools.

About ASPS
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 6,700 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. For more information, please visit the ASPS website at www.plasticsurgery.org.