Not trying to be inflammatory. For anyone who knows me, you know I do not advocate cosmetic surgery for teens. But this journal article from October 2017 Aesthetic Surgery Journal “Safety of Cosmetic Surgery in Adolescent Patients” caught my eye. The question not only is should teens have cosmetic surgery, but is it SAFE?
They looked at a prospective cohort of patients between 2008 and 2013. They looked at demographics, surgical procedures, major complications in patients ages 10-19 vs. patients older than age 20. Risk factors were analyzed for age, gender, BMI, smoking, diabetes, type of surgical facility, procedure, and combined procedures.
Note: Many procedures we do in younger patients aren’t classically “cosmetic.” They include breast reductions, gynecomastia (when boys have breasts), and otoplasty, which are covered by insurance.
Results
- 3519 adolescents, 124,409 older patients
- Adolescent group was
- more men (20% vs 6%)
- lower BMI (22.6 vs. 24.4)
- lower diabetes (0.8% vs. 1.9%)
- fewer smokers (5.9% vs. 8.3%)
- Adolescents did breast surgeries, followed by face, and then body.
- Adolescents had a lower incidence of major post operative complications (0.6% vs. 1.5% for single procedure, 1.2% vs 3% for combined procedure)
- The most common complication in teens was hematoma, followed by infection.
- BMI was the only risk factor associated with increased risk of post op complications in adolescents.
- This study did not look at minor complications.
Their thoughts? Cosmetic surgical procedures in teens are safe with lower rates of major post op complications.
My thoughts? Good to know, but just because it is safe, doesn’t mean you should do it. I do some surgeries in adolescents, but rarely. In their article they talk about the controversy around cosmetic surgery in adolescents. I will repeat their concerns here, as I think they are good to consider.
- Are they mature?
- Do they understand the risk of the procedure?
- Are they still developing?
- What is their motivation?
- Are their expectations realistic?
- Do they have unrealistic expectations or pressures because of social media?
In a critique of the study, they noted
- the majority of the adolescents were 16-19, with a mean age of 18.
- Many of the adolescents were doing smaller scale surgeries.
- The data was taken from only Board Certified Plastic Surgeons, and as we know, many “cosmetic surgeons” come from other specialties.
- This study and the complication rates reported are only for complications requiring surgery or hospitalization.