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Are teenagers appropriate candidates for cosmetic plastic surgery? Our 15 year old son is very bothered by the appearance of his nose and has asked us for a “nose job”. At what age could he consider having such surgery?

Paula K, Dana Point

Reality TV shows and frequent articles in the lay press about aesthetic surgery have fueled a desire for such procedures in young and old alike. Your question has a few important components which deserve consideration. A parent must be present when any patient under the age of 18 comes in to see us. On the other hand, we will never agree to do an elective aesthetic procedure on a youngster at the parent’s request IF the child does not express an understanding of the procedure and have a strong desire for the improvement!

Age by itself is not a determining factor in deciding suitability for nasal surgery. We have corrected many a nasal deformity in infants with cleft lip nasal deformities. But when it comes to a purely cosmetic situations, we must be certain that the patient is physically and mentally prepared for such a change. The child’s nose should have assumed an adult shape and size before elective surgery should be considered. This usually occurs by the time the adolescent is somewhere between 13-16 years of age. But as occurs with all adult patients as well, it is very important to have a detailed consultation with the minor to determine the exact areas of concern and to assess the child’s expectations. The surgeon then has to assess whether or not the child is mature enough to make such a decision and if the degree of deformity warrants surgical correction.

A definite red flag would be a patient with a level of concern out of proportion with the degree of deformity, or an unrealistic expectation not only of what the surgical results will look like but also how it will affect the youngster. But in the right patient, very satisfactory results can be achieved with nasal surgery in an adolescent. Different time tables pertain to other procedures. We will not do an ear pin back on a child too young to be bothered by the protruding ears. By the time a child enters school, teasing usually starts and a procedure can do a lot to restore a child’s self confidence. A child of 5-7 years of age can benefit from a pin back of protruding ears. A teen aged girl with enormous breasts can benefit from a breast reduction. Breas enlargement in an adolescent male can lead to self confidence issues and removal of excess tissue in such cases is greatly appreciated by most young men. But some aesthetic procedures such as breast augmentation and liposuction should be reserved for young adults of at least 18 years of age.

Here are two examples of younger patients who benefited greatly by receiving a cosmetic procedure at a younger age.

14 year old Hispanic boy with a large nose who in particular, did not like his nasal profile, and two years after a rhinoplasty at age 16. The improvement did much to improve this youngster’s self esteem.

12 year old girl with protruding ears and a year later at age 13. Repairing a protruding ear is a one hour, out patient procedure that can do a lot to improve a child’s self esteem and diminish teasing (“Mickey Mouse”, “Dumbo”, etc).

If you have any specific questions about cosmetic procedures, your best bet would be to see a qualified plastic surgeon to review your options. Please feel free to contact our office at 949-997-0796 to set up an appointment with Dr. Bunkis; check out our web site at to see further examples of similar patients.