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

Victoria Clayton • E-mail

When Courtney Powers graduated from high school last year, she didn’t receive a new computer or a trip to Europe. The North Carolina teen got a pair of D-cup breast implants.    

“My breasts hadn’t grown since I was 16,” says Powers, who underwent cosmetic surgery two days after her 18th birthday. “I was a 36AA and my mom and dad knew I was very self-conscious.”

Powers earned half the money for the surgery by working at a bowling alley and baby-sitting. Her parents chipped in the rest as a graduation gift.

Although teens make up just 2 percent of cosmetic surgery patients in the United States, their numbers have grown. In 2006, procedures performed on kids ages 13 to 19 totalled 244,124, including about 47,000 nose jobs and 9,000 breast augmentations, according to the American Society of Plastic Surgeons (ASPS).

And it's become trendy for nose jobs, breast implants, teeth whitening, skin resurfacing and liposuction to top a grad’s wish list, says Dr. Roxanne Guy, ASPS president.

She and other experts say the desire for teen cosmetic surgery has been fueled by television shows depicting extreme makeovers, as well as society's growing acceptance of plastic surgery in general.

“Teens certainly are more aware of plastic surgery options now,” says Guy.

But if a teen wants a nip or tuck, should parents comply? And at graduation time, is a boob job or liposuction really an appropriate reward for years of academic achievement?

Living in the now
L. Kris Gowen, an adolescent developmental psychologist at Portland State University, says she worries that many teens aren’t equipped to make decisions that will potentially impact their health and the rest of their lives.

Teens and plastic surgery Plenty of teens express a desire to change something about their faces and bodies. Before you give them permission (and the money) to go forward, consider these points: — Find out why your kid wants surgery. To be more popular? To look like a favorite celeb? Once you get answers, you may discover your teen is just buying into a current media-fueled trend. Or you may find that he or she does need help, just not from a surgeon. Consult a mental health professional if you feel the issue runs deeper than you can handle. — Check yourself, too. Doctors say a parent who is overly enthusiastic about a child’s plastic surgery is a red flag. — Consult experienced, board-certified plastic surgeons. A reputable doctor can help you determine if a surgery is appropriate for your teen.

“Adolescents generally ground themselves in the here and now and in more concrete thinking,” she says. “They don’t tend to think of the long-term effects or risks of surgery but, rather, just the concrete result of ‘I’ll look better.’”

And who can say if that Ashlee Simpson nose or DD chest will still be cute in 20 years?

As with any surgery, there are risks, including bleeding and infection. And a fair number of cosmetic surgeries — perhaps as many as 20 percent — must be revised.

There’s also reason to be wary of the psychological state of some surgery candidates, as well as the surgery’s impact on mental health.

Although researchers haven’t concluded surgery can lead to suicide, four epidemiologic studies have found that the risk of suicide among women with breast implants is two- to threefold higher than among other women. One theory is that some people who get surgery are actually suffering from a psychological disorder known as body dysmorphic disorder (BDD), in which they falsely believe they are unusually ugly. A study last year found that suicide rates among patients with BDD was 45 times higher than in the general population.

“We know that from 5 to 15 percent of all cosmetic surgery patients have BDD” and it tends to first emerge in adolescence, says David D. Sarwer, an associate professor of psychology at the Center for Human Appearance at the University of Pennsylvania School of Medicine in Philadelphia.

“Some of these teens who want surgery may be suffering from BDD," he says. "Psychotherapy and [antidepressants] are much more effective for BDD than cosmetic surgery.”

NBC VIDEO More teens have plastic surgery March 8: TODAY's Natalie Morales talks with Dr. Gail Saltz, a psychiatrist and show contributor, and Dr. Alan Gold, a board-certified plastic surgeon, about teen cosmetic surgery. Today Relationship

Janice Styer, an adolescent counselor in Wernersville, Pa., warns parents to also carefully consider the message surgery sends to kids.

“In working with adolescent females I see this as just another quick fix. The thing that bugs me is the lack of coping skills we’re giving kids. We’re saying, ‘If you can’t meet the expectations of society, just get surgery,’” says Styer.

Others note the irony of rewarding brainy accomplishments with body fixes.

“By giving teen girls, in particular, surgery we’re just sending this message to them that they can be anything they want to be — they can go to any school or do anything in life — as long as they look a certain way on the outside,” says Courtney Macavinta, co-author of “Respect: A Girl’s Guide to Getting Respect and Dealing When Your Line Is Crossed.”

It’s not the right message to tell them that we’re glad they’re smart, says Macavinta, but now do something about the nose.

“I’m all for taking a shower, combing your hair and getting a cute outfit, but there is only a tiny percentage of people whose profession and success rely on appearance,” says Macavinta. “The girls who thrive and prosper in life very quickly invest their energy other places — like their brains, compassion and humor.”

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