Cosmetic Surgeons Focus More on Teen Set

Cosmetic Surgeons Focus More on Teen Set

WASHINGTON, April 18-Cosmetic surgery procedures among children and teens rose by 9% in 2004, compared with 2003. Cosmetic surgery, says the president of the American Society of Plastic Surgeons, whose members perform most of it, is all part of growing up.

Scott Spear, M.D., the group's president, says that in his mind cosmetic procedures are done generally to help the child in much the same way that a parent will take a child to the orthodontist for teeth straightening, or that parents will help a child with diet or exercise to lose weight.

Dr. Spear, who is also professor and chair of plastic surgery at Georgetown, conceded that there was a whopping rise in injections of Botox among young people, but he warned that such statistics may signal a trend where none exists.
For instance, ASPS data state that 8,978 Botox injections were administered to patients age 18 or younger in 2004 -- a whopping 244% increase over injections in 2000 and up 60% from the number of injections given in 2003.

Botox, which is a paralyzing agent, is widely promoted for its ability to smooth away facial wrinkles, and Dr. Spear says that he, too, was surprised and puzzled when he first saw the number of injections given to teens. "It would be surprising if Botox were used in teens to treat wrinkles," he said.

The more likely explanation, he said, is that the injections were used to treat migraine or muscle spasm, which are two other fairly common uses for Botox.
The statistics on plastic surgery procedures are issued annually by the ASPS. Procedures for patients 18 or younger is a separate category. Rhinoplasty was listed as the number one surgical procedure for teens -- 51,931 done in 2004 -- followed by ear surgery (otoplasty).

While rhinoplasty is almost never covered by insurance, otoplasty, which is surgery to pin ears back against the head, may be covered by insurance, but Dr. Spear says that insurers are more likely to pay for the procedure if the patient is four or five than if the patient is 20-something.

The otoplasty example, he said, illustrates the difference between reconstructive and cosmetic surgery. "Reconstructive surgery is surgery to restore to normal appearance, cosmetic is surgery to enhance the normal.

"In the case of otoplasty, it is not normal to have ears that stick out. For a child, there is a time when kids start noticing differences and when this happens the kid who is different can get very self conscious and other kids can be very cruel about differences," he said. "So otoplasty is a reconstructive procedure for a child."

Dr. Spear pointed out that plastic surgeons don't operate on every teen that wants a straighter nose or bigger breasts -- although 3,962 teens did get bigger breasts via surgery in 2004 and 3,631 teenage boys had breast reduction. In either case the teen is typically referred by a pediatrician and is accompanied by a parent to the surgeon's office. And, again, there are medically valid reasons for either surgery, said Dr. Spear.

Making the case for breast reduction to treat gynecomastia, he said. "a tablespoon or a quarter cup of breast tissue in an adolescent boy can be very alarming to him." Likewise some teenage girls have "absolutely no breast development at age 17 or may have a breast on one side, but not the other."

But Dr. Spear added that it is also possible that some teenage girls are getting breast augmentation surgery for cultural reasons -- he speculated that in southern California or Florida large breasts are more culturally desirable than in "more conservative areas like Washington or Cleveland." Even so, he said that "I don't believe there is an epidemic of teens getting breast augmentation surgery

By Peggy Peck, Senior Editor, MedPage TodayApril 18, 2005Also covered by: Yahoo!
http://www.medpagetoday.com/tbindex.cfm?tbid=898