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Derrick et al. Teen aesthetic surgery may eliminate bullying

Beauty pays routine surgical practices [27] . They seem to be unaware
Hamermesh [24] argues that those who are considered of the extensive literature that discusses standards
less attractive will suffer economically as compared to of normality [28-31] and other opinions based on actual
their colleagues who are equally as qualified, trained, clinical experience with patients and their families.
and intelligent, but are considered more attractive
by social means. This disadvantage equates to a Countless evidence provided by Michael Olding
[3]
loss of “$140,000 over a lifetime compared to the in Friedman’s article seems to show that plastic
earnings of an average-looking worker”. In his concept surgery can actually limit psychological consequences
referred to as “protecting the ugly”, Hamermesh [24] and physiological consequences. For example,
compares the level of disadvantages that a less otoplasty helps remove what others coin “dumbo ears”,
attractive person experiences to that of an individual which in effect removes the bullying stimulus. Other
subject to discrimination based on gender, race, or operations, such as breast reduction, gynecomastia
disability status. Thus, he argues that the government and macromastia, can actually help with physiological
should protect “ugly” individuals in the same ways consequences as extremely large breasts can
as it has historically protected other disadvantaged cause back and shoulder pain. Through undergoing
groups. This protection would be for the benefit of cosmetic surgery, procedures can alleviate significant
both the “ugly”, as well as the economy as a whole. psychological strain and improve self-esteem.
He suggests correcting this net worth disparity by Moreover, it is unfair that teenagers should be
cash compensation from the government. He fails excluded from plastic surgery simply due to their
to mention, that cash contribution could be used to age, especially when some parts of the body such as
correct the very defaults that qualify for the beauty the nose, reach complete maturation in the teenage
impaired (see three cases below). years. Furthermore, plastic surgery is not harming
anyone else and only helps boost self-confidence of
The American college of obstetricians and the patient, and thus should be allowed for anyone, no
gynecologists recently published a committee opinion matter what age, seeking out aesthetic surgery.
based on the increasing interest of adolescents in
breast and labial surgery. The committee emphasizes CASE REPORT
the necessity of physical maturity and emotional
readiness when dealing with adolescent patients, as All of our patients have been operated in our outpatient
well as “education and reassurance regarding normal surgery facility where they were discharged to go home
variation in anatomy, growth, and development” [25] . or to a hotel that night. All of our previous patients
The necessity of these procedures is often questioned have been treated with valium and ketamine sedation
and highly controversial, as nonsurgical alternatives exclusively. We have performed more than 30,000
appear to be much more practical and less invasive aesthetic operations since 1978 to the present day;
for adolescents. Dr. Abbey B. Berenson believes that all have been performed with valium and ketamine
most women will likely never notice the variance in sedation, discharged same day. In 40 years, there have
appearance of external genitals, and those that do feel been about 100 patients under 18 years of age none
insecure about their genitalia should be well informed experienced complications, deep vein thrombosis or
and counseled on this natural variance [26] . This normal mortality ever. We present 3 cases in detail of teenage
variation among women includes size, shape, and cosmetic surgery to illustrate that earlier is better.
appearance of external genitalia including the labia
minora. The committee argues that asymmetry is Patient 1
seen as a “normal variant” and “despite increased Our first patient was a 15-year-old girl who had a
awareness and focus on the appearance of the peculiar habitus, perhaps Ehlers-Danlos syndrome
external genitalia, no consensus on the definition of where she had very lax skin, a hypoplastic chin and a
labial hypertrophy or criteria for surgical intervention large nose. She was depressed because she looked
has been established” [25] . In another opinion published far older than her older sister and even her mother.
by The American College of Obstetricians and They were unable to find anyone in her native England
Gynecologists, the committee argues that patients homeland to consider doing aesthetic surgery for a
who are already anxious and insecure regarding their 15-year-old girl. Thus, she was an outcast at school,
genital appearance or sexual function may actually was ridiculed and had a terrible self-image. The patient
be “further traumatized” by such procedures that lack had even contemplated suicide.
supporting data on safety and efficacy. The committee
states it is “deceptive” of physicians to give the As seen in the Figure 1, we did a face-lift, brow-lift,
impression that such procedures are accepted and rhinoplasty, and chin augmentation for this girl as an
180 Plastic and Aesthetic Research ¦ Volume 4 ¦ October 26, 2017