As the popularity of plastic surgery increases among teenagers, Dr. Rod J. Rohrich has published new research suggesting that there are very few formal guidelines and insufficient studies specific to teenaged populations and offers a set of basic considerations for plastic surgeons treating teenaged patients.
In a new review published by Dr. Rod J. Rohrich and Dr. Min-Jeong Cho in Plastic and Reconstructive Surgery, the authors found a severe lack of information and few studies that focus on safety and efficacy of plastic surgery in the teenaged population. With over 200,000 teens receiving some type of plastic surgery treatment every year, the review offers guidelines based on the current research, and offers areas for future study.
“There is a myriad of literature on the psychological and ethical issues concerning plastic surgery in teenagers,” the review found, ” However, studies regarding the safety of performing plastic surgery in this population are scarce.”
The study suggests that increased use of social media and associated peer feedback may contribute to body image and self-esteem issues among teens which plastic surgeons should consider when evaluating a teenage patient’s candidacy for treatment.
While more research and established guidance exists for surgical procedures such as rhinoplasty and breast surgery, the study found little research on the more common and increasingly popular non-invasive procedures such as fillers, injectables, and various skin treatments.
“We were surprised to find that only eight studies have been performed that evaluate laser, chemical peel, and microdermabrasion use in adolescents, and zero outcomes studies on injectable use despite its high popularity,” says Dr. Rohrich, who is also the Editor in chief of the Journal of Plastic and Reconstructive Surgery. “It’s safe to say that more research is needed in these areas.”
The review includes discussion about several considerations for teenage patients such as potential hormonal interactions with various treatments, acne and long term scarring, and the social and developmental impact that bullying may have on children and teenagers with congenital deformities, among others.
“While a rhinoplasty or ear surgery can be performed safely by a board-certified surgeon and are, in many cases, appropriate for an adolescent, other cosmetic procedures such as breast augmentation, liposuction or injectables are typically not recommended for minors for several reasons, including lack of research,” said Dr. Rohrich. “It’s concerning that there has been a surge in the use of injectables in young patients to achieve augmented cheeks and lips when there is no evidence that these procedures are safe for adolescents.”
Based on the literature reviewed, the study offered guidelines for some of the most popular procedures:
Rhinoplasty: In children and teens with significant nasal deformities, nose reshaping may be appropriate. It is recommended that surgery not be performed until nasal growth is completed – typically age 15 to 16 in females and age 16 to 18 in males. In some situations, such as a child with a cleft lip, a rhinoplasty may be performed at a younger age.
Breast reduction: To alleviate back and neck pain, breast reductions are commonly performed on teenaged girls; however, it’s important to ensure that surgery is performed after the patient has completed breast development, which typically occurs between 12 and 19 years of age.
Otoplasty: Surgery to correct ear deformities can be performed as young as age five, as this is when the ear is almost fully grown.
Liposuction: Unless performed as part of a breast reduction surgery, it is not recommended that a teenager undergo liposuction.
Breast augmentation: Candidates with uncommon chest deformities or congenital breast asymmetry are generally the only cases in which a board-certified plastic surgeon should deem breast augmentation appropriate for a teenager.
“Patient safety should always be the top priority of any plastic surgeon,” says Dr. Rohrich. “This important review clearly indicates the need for more research on the long term safety and efficacy of plastic surgery performed on teens, especially in the non-invasive areas which are rapidly becoming the most popular procedures.”
About Rod J. Rohrich, M.D., F.A.C.S.
Dr. Rod Rohrich is a Dallas, Texas board certified plastic surgeon, Distinguished Teaching Professor and was the Founding Chair of the Department of Plastic Surgery at UT Southwestern Medical Center in Dallas, Texas. Dr. Rohrich graduated from Baylor College of Medicine with high honors, and completed residencies at the University of Michigan Medical Center and fellowships at Massachusetts General Hospital/Harvard (hand/microsurgery) and Oxford University (pediatric plastic surgery). He has served as president of the American Society of Plastic Surgeons, the largest organization of board certified plastic surgeons in the world. He repeatedly has been selected by his peers as one of America’s best doctors, and is the only plastic surgeon to receive one of his profession’s highest honors three times in his career-the Plastic Surgery Educational Foundation Distinguished Service Award, which recognizes his contributions to education in plastic surgery. Dr. Rohrich participates in and has led numerous associations and councils for the advancement of plastic and reconstructive surgery.