Way to go, grad! Here's a check for a new nose

Sarwer doesn’t wholly agree: “From a societal perspective, the reality is that whether we like it or not, our appearance does seem to matter.”

Studies show that attractive people are treated more favorably and that a positive body image can account for up to one-third of self-esteem, he says.

Parental pressures
Sometimes the driving force behind teen cosmetic surgery isn't the kids — it's the parents.

“Parents who have familiarity with plastic surgery will tend to have children who have more plastic surgery,” says Dr. Brent Moelleken, a Beverly Hills plastic surgeon. “But a reputable doctor will make sure patients aren’t being pushed by their parents, though. Surgery is a serious decision and it works best if the patient is internally motivated — not pressured by a parent or someone else — and has reasonable expectations.”

Atlanta plastic surgeon Dr. Brian Maloney says he's careful during consultations to gauge if the motivation is coming from the teen or from "an overly worried mom who is a socialite and is concerned if a hump on daughter’s nose is going to impact marital prospects down the road.” He often asks to speak with the teen alone to gauge if he or she really wants the surgery.

However, surgeons will admit that sometimes it’s a complicated judgment call.

Take the case of Katie Underdown of Georgia. Last year, the 17-year-old had a nose job and a chin implant by the same surgeon who did multiple surgeries on her mother, Jan, and several of her mom’s friends. Although the teen had a deviated septum, a medical condition that makes it harder to breath, she initially balked at surgery. Her mother urged her on, though.

“I told her, ‘It doesn’t bother you right now but it may later. Let’s just get it fixed.’ I had a great surgeon, I was able to pay for it and nurse her back,” explains Jan Underdown. “Katie had a recessed chin like me and I said, ‘Put the chin implant in.’ She did it. It turned out great. I think of it like her braces. You fix what you know is an issue and then you go on and live your life.”

Although the teen is pleased with the outcome, she’s not enthusiastic about surgery in general. “I think people should be happy with the way they look and shouldn’t feel obligated to have surgery,” she says. “But I will say also that I look better and breathe better now. So in my case it was a good choice.”

Sarwer notes that the majority of adults who undergo plastic surgery also report being satisfied with the outcomes. “Body image improves after surgery. Self-esteem and quality of life can improve as well,” he says. “However, more studies are needed before we can say that kids benefit the same way adults do.”

Courtney Powers doesn’t need any study to convince her. Bathing suit season is rolling around and she’s already ordered two new suits from Victoria’s Secret.

“[The surgery] has made me feel better. Now I have more self-confidence. When I go out … I’m not afraid of my fake padding falling out. I feel like I can look at myself and say, ‘I’m really pretty.’ Before, something seemed like it was missing. Now there’s nothing missing.”

Is she saving for another surgery?

“Not now,” says Powers, “but once you have your first surgery it’s like a huge open door. You do see how easy it is to fix something.”

Victoria Clayton is a freelance writer based in California and co-author of "Fearless Pregnancy: Wisdom and Reassurance from a Doctor, a Midwife and a Mom," published by Fair Winds Press.

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