SOUTH JORDAN, Utah -- Children teased for having "Dumbo" ears. A young soccer player who broke her nose during a game. A 17-year-old so concerned with what she perceived as her own flat breasts that she wouldn't go swimming with friends.
These are all examples of problems that Grant A. Fairbanks, a South Jordan plastic surgeon, says have led adolescent Utahns to seek "better quality of life" in the form of surgery at his office over the years.
"Now of course, we can't guarantee that our surgery will do that," he said in a recent interview with FOX 13 News. "But experience has told us and has shown us that yes, we can do this and improve this child's life."
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While Fairbanks says he's seen positive outcomes among those who are ultimately deemed good candidates for plastic surgery, other experts are more concerned about the trend - as well as what it says about how young adults are feeling about themselves.
"It's spooky, actually, how serious it is," said Susan Madsen, executive director of the Utah Women & Leadership Project at Utah State University, of research that shows girls in elementary school are already scrutinizing their own bodies.
"Can you imagine at 8 years old worrying about what your body looks like already?" she asked in a recent interview. "And then by the time you're 13, you're beating yourself up all the time trying to manipulate photos and making sure you've got the right angles on your selfies and so forth?"
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Adolescent operations make up a small percentage of the overall number of plastic surgery procedures done each year - about 1% nationwide in 2023.
Research shows nose jobs and breast augmentations have historically been the most common operations among 13- to 19-year-olds. The most recent data from the American Society of Plastic Surgeons also show that less-invasive procedures, like injections and fillers, are up more than 60% among teens since 2014.
Those numbers are not broken down by state, so it can be difficult to know exactly what's happening in Utah. But Madsen said researchers identified a "disturbing" trend here several years ago of parents "giving breast augmentation surgeries to their daughters when they graduated from high school."
That trend, she said, reflects a complex set of circumstances influencing Utah teens - from societal beauty standards to the pressures of social media and even the influence of parents who just want their children to "feel good."
Utah's status as one of the top spots for plastic surgery in the nation can also have an impact on adolescents, Madsen said.
"If mothers talk about getting plastic surgery themselves in front of their daughters, I'll tell you - the impact on the daughters is quite serious at an early age," she said. "Because what they see in themselves is that 'I'm not good enough. I need to think about changing myself.' Even if they're 8, 9, 10, 11, 12 years old."
'We have to be careful'
The American Society of Plastic Surgeons urges doctors to be judicious when evaluating adolescent patients, especially since they can lack emotional and physical maturity.
"This is one where we have to be careful," agreed Fairbanks, a board-certified plastic surgeon and member of the American Society of Plastic Surgeons.
The society recommends doctors take into consideration a number of factors when deciding whether to operate on teenagers - including a patient's goals, emotional and physical maturity and whether the operation was his or her idea.
"Bottom line is there has to be good decision-making on the part of the surgeon," Fairbanks said. "There has to be informed consent. And the parents have to be involved."
Research published in the Journal of the American Society of Plastic Surgeons in 2018
suggests some procedures are more appropriate among teens, especially if bullying led them to seek surgery.
Rhinoplasty, or nose jobs, are the most commonly performed surgery on this age group, amid "a growing body of knowledge that teenagers with significant cosmetic nasal deformities undergo a lot of psychological trauma and bullying," the research notes. But
most surgeons wait to perform these procedures until age 16 to 18 for boys and 15 to 16 for girls, to allow the nose to finish developing and avoid inhibiting the growth of the face.
Another common procedure is otoplasty, which is done to correct protruding ears. The surgery is sometimes done on patients as young as 5 years old, by which point the ears have largely reached their adult size. And the decision to operate is usually predicated on "the parents' anticipation of future psychosocial impact and possible bullying," according to the research.
But the study cautions that other procedures in teens - such as breast augmentations - are more "controversial." The authors concluded that they would not recommend breast augmentations for those younger than 18, given their "psychological and emotional immaturity" before that point. They also recommended waiting in most cases until 18 in for chemical peels, cosmetic lasers and injectables like Botox
"Just because you can," the authors wrote, "doesn't mean you should."
Fairbanks said he commonly performs otoplasties for young patients. But he decided not to operate on the young girl who broke her nose playing soccer, since she was continuing to participate in the sport and he also had concerns about stunting the growth in her face.
As for the 17-year-old patient who was concerned she had flat breasts, Fairbanks said he would typically require a patient to wait until she was at least 18 for the procedure. But he decided to make an exception after speaking with her psychiatrist, who noted the girl's history of anxiety and depression.
"The psychiatrist interestingly said that he was not a fan of cosmetic surgery as a whole," Fairbanks recounted. "However, in this particular case, [he said] this would be beneficial for this particular patient. We went ahead and did the procedure. And interestingly enough, it was a home run. Her whole self-esteem changed, and she was able to socialize without being concerned."
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