Teens seek plastic surgery, breast jobs, to fit in

LOS ANGELES (Reuters) - A young boy is teased constantly about his “Dumbo” ears; a 15-year old girl refuses to takes showers at school because her breasts are lopsided.

Different body images are shown in this before and after drawing by a six-year-old boy born with large ears shown in this publicity photo from the book "The Kindest Cut - Teenage Plastic Surgery: Reshaping the Body and Soul", released to Reuters June 11, 2008. The book's author, New York plastic surgeon Frederick Lukash, says a nip and tuck may be the kindest cut for teens who, unlike adults, are mostly looking to fit in rather than stand out. REUTERS/Handout

Plastic surgery (ear-pinning, a breast implant) could swiftly fix both problems for the humiliated teens.

But where to draw the line on cosmetic surgery for adolescents in a world where body image and self-esteem seem to trump resilience and individuality?

“Sometimes, one hour for an operation and a few days to recover are better than a lifetime of psychoanalysis,” said Dr Frederick Lukash, a New York plastic surgeon who has specialized in adolescents for more than 20 years.

Lukash, who combines surgery with psychiatry and art therapy, says a nip and tuck may be the kindest cut for teens who unlike adults, are mostly looking to fit in rather than stand out.

“Adults who want plastic surgery are interested in rejuvenation. Kids largely want to be part of the crowd, not to be picked on or bullied.

“Every parent wants their child to rise above the crowd. But first they have to feel part of it and they can’t do that if they are tormented,” Lukash told Reuters.

The American Society of Plastic Surgeons (ASPS) reports that 87,600 surgical operations were performed on 13-19 year olds in 2007, mostly for breast reduction in young males and nose reshaping. The teen surgeries represent 5 percent of overall procedures.

But the subject is such a hot potato that Lukash is having difficulty finding a publisher for his book “The Kindest Cut”. It is aimed at parents and child therapists and combines pictures of extreme cases along with before and after artwork from dozens of his embarrassed young patients.

“(Publishers) say it’s not for our house, or it’s too controversial. There are people who won’t even read it who will decide it’s not politically correct. But I look on it as quality of life surgery,” he said.

Ann Kearney-Cooke, a Cincinnati-based psychologist, body image expert and author of “Change Your Mind Change your Body,” has reservations about surgery as a fix for low self-esteem.

“For someone whose body part is so different from the norm, I would make an exception for that,” Kearney-Cooke said.

“But self-esteem is not just about how big your ears are. Instead of rushing to the plastic surgeon, let’s help these kids develop skills so they can be effective at handling these situations or saying ‘don’t talk about my ears like that’,” she told Reuters.

Lukash says plastic surgery is not a panacea and he does not operate without extensive consultations with parents and therapists. He often tells patients they are too young, or refers them for psychological help.

But he says surgery has made a profound difference to his patients, even in the controversial area of breast implants which are generally discouraged by the ASPS for the under-18s.

“I dealt with a 14 year-old girl who had breasts that sagged like a 60 year-old woman. She wouldn’t do PE, go in the shower or go to camp. She started acting out and developed an eating disorder,” Lukash said. He performed a breast lift and the eating disorder went away.

Kearney-Cooke said there has always been pressure for kids to fit in. “What is different is that the focus has switched to appearance and image making.

“We need to help boys and girls figure out what are their signature strengths and how to play them up. Instead we have a quick fix mentality where you can change the shape of your nose, versus thinking that these are the cards you’ve been dealt, and how do you play them?.” she said.

Lukash however said that appearance does matters in modern society. “It’s why we shower and get a haircut. It is hard to deny out of hand the individual’s right to be improved.”