When you hear of plastic surgery, what do you think of? A Hollywood star trying to delay the effects of aging? People who want to change the size of their stomachs, breasts, or other body parts because they see it done so easily on TV?

Those are common images of plastic surgery, but what about the 4-year-old boy who has his chin rebuilt after a dog bit him? Or the young woman who has the birthmark on her forehead lightened with a laser?

What Is Plastic Surgery?

Just because the name includes the word "plastic" doesn't mean patients who have this surgery end up with a face full of fake stuff. The name isn't taken from the synthetic substance but from the Greek word plastikos, which means to form or mold (and which gives the material plastic its name as well).

Plastic surgery is a special type of surgery that can involve both a person's appearance and ability to function. Plastic surgeons strive to improve patients' appearance and self-image through both reconstructive and cosmetic procedures.

• Reconstructive procedures correct defects on the face or body. These include physical birth defects like cleft lips and palates and ear deformities, traumatic injuries like those from dog bites or burns, or the aftermath of disease treatments like rebuilding a woman's breast after surgery for breast cancer.
• Cosmetic (also called aesthetic) procedures alter a part of the body that the person is not satisfied with. Common cosmetic procedures include making the breasts larger (augmentation mammoplasty) or smaller (reduction mammoplasty), reshaping the nose (rhinoplasty), and removing pockets of fat from specific spots on the body (liposuction). Some cosmetic procedures aren't even surgical in the way that most people think of surgery — that is, cutting and stitching. For example, the use of special lasers to remove unwanted hair and sanding skin to improve severe scarring are two such treatments.

Why Do Teens Get Plastic Surgery?

Most teens don't, of course. But some do. Interestingly, the American Society of Plastic Surgeons (ASPS) reports a difference in the reasons teens give for having plastic surgery and the reasons adults do: Teens view plastic surgery as a way to fit in and look acceptable to friends and peers. Adults, on the other hand, frequently see plastic surgery as a way to stand out from the crowd.

The number of teens who choose to get plastic surgery is on the rise. According to the ASPS, over 333,000 people 18 years and younger had plastic surgery in 2005, up from about 306,000 in 2000.

Some people turn to plastic surgery to correct a physical defect or to alter a part of the body that makes them feel uncomfortable. For example, guys with a condition called gynecomastia (excess breast tissue) that doesn't go away with time or weight loss may opt for reduction surgery. A girl or guy with a birthmark may turn to laser treatment to lessen its appearance.

Other people decide they want a cosmetic change because they’re not happy about the way they look. Teens who have cosmetic procedures — such as otoplasty (surgery to pin back ears that stick out) or dermabrasion (a procedure that can help smooth or camouflage severe acne scars) — sometimes feel more comfortable with their appearance after the procedure.

The most common procedures teens choose include nose reshaping, ear surgery, acne and acne scar treatment, and breast reduction.

Is Plastic Surgery the Right Choice?

Reconstructive surgery helps repair significant defects or problems. But what about having cosmetic surgery just to change your appearance? Is it a good idea for teens? As with everything, there are right and wrong reasons to have surgery.

Cosmetic surgery is unlikely to change your life. Most board-certified plastic surgeons spend a lot of time interviewing teens who want plastic surgery to decide if they are good candidates for the surgery. Doctors want to know that teens are emotionally mature enough to handle the surgery and that they're doing it for the right reasons.

Many plastic surgery procedures are just that — surgery. They involve anesthesia, wound healing, and other serious risks. Doctors who perform these procedures want to know that their patients are capable of understanding and handling the stress of surgery.

Some doctors won't perform certain procedures (like rhinoplasty) on a teen until they are sure that person is old enough and has finished growing. For rhinoplasty, that means about 15 or 16 for girls and about a year older for guys.

Girls who want to enlarge their breasts for cosmetic reasons usually must be at least 18 because saline implants are only approved for women 18 and older. In some cases, though, such as when there's a tremendous size difference between the breasts or one breast has failed to grow at all, a plastic surgeon may get involved earlier.

Things to Consider

Here are a few things to think about if you're considering plastic surgery:

• Almost all teens (and many adults) are self-conscious about their bodies. Almost everyone wishes there were a thing or two that could be changed. A lot of this self-consciousness goes away with time. Ask yourself if you're considering plastic surgery because you want it for yourself or whether it's to please someone else.
• A person's body continues to change through the teen years. Body parts that might appear too large or too small now can become more proportionate over time. Sometimes, for example, what seems like a big nose looks more the right size as the rest of the person's face catches up during growth.
• Getting in good shape through appropriate weight control and exercise can do great things for a person's looks without surgery. It's never a good idea to choose plastic surgery as a first option for something like weight loss that can be corrected in a nonsurgical manner. Gastric bypass or liposuction may seem like quick and easy fixes compared with sticking to a diet. Both of these procedures, however, carry far greater risks than dieting, and doctors should reserve them for extreme cases when all other options have failed.
• Some people's emotions have a really big effect on how they think they look. People who are depressed, extremely self-critical, or have a distorted view of what they really look like sometimes think that changing their looks will solve their problems. In these cases, it won't. Working out the emotional problem with the help of a trained therapist is a better bet. In fact, many doctors won't perform plastic surgery on teens who are depressed or have other mental health problems until these problems are treated first.

What's Involved?

If you're considering plastic surgery, talk it over with your parents. If you're serious and your parents agree, the next step is meeting with a plastic surgeon to help you learn what to expect before, during, and after the procedure — as well as any possible complications or downsides to the surgery. Depending on the procedure, you may feel some pain as you recover, and temporary swelling or bruising can make you look less like yourself for a while.

Procedures and healing times vary, so you'll want to do your research into what's involved in your particular procedure and whether the surgery is reconstructive or cosmetic. It's a good idea to choose a doctor who is certified by the American Board of Plastic Surgery.

Cost will likely be a factor, too. Elective plastic surgery procedures can be expensive. Although medical insurance covers many reconstructive surgeries, the cost of cosmetic procedures almost always comes straight out of the patient's pocket.

Your parents can find out what your insurance plan will and won't cover. For example, breast enlargement surgery is considered a purely cosmetic procedure and is rarely covered by insurance. But breast reduction surgery may be covered by some plans because large breasts can cause physical discomfort and even pain for many girls.

Plastic surgery isn't something to rush into. If you're thinking about plastic surgery, find out as much as you can about the specific procedure you're considering and talk it over with doctors and your parents. Once you have the facts, you can decide whether the surgery is right for you.

Reviewed by: Steven Dowshen, MD
Date reviewed: December 2009
Originally reviewed by: Paul H. Izenberg, MD