During Annie's junior year of high school she was focused on raising her grades to make sure that she could go to the college of her choice. So it took her parents by surprise when, in Annie's senior year, her concerns shifted to a different kind of improvement. On her 18th birthday, Annie begged her parents to finance breast implants, convincing them that their money would be well spent by giving her the enhancement she believed she needed to be successful at college.
"Back to school" used to mean shopping for notebooks, sharpening pencils and sometimes indulging in a new outfit or two. Excitement and anxiety filled the air as students' vacations or summer jobs ended and as preparations for a new semester began. Today, more and more teens are spending their summer days -- and savings -- preparing to start this new chapter in their lives with surgically refreshed bodies and faces.
Last year, according to statistics provided by the American Society for Aesthetic Plastic Surgery (ASAPS), 15 percent of all procedures in the U.S. were performed on patients under age 21. For young, high school students like Annie, the most popular ones included breast augmentation (4,153), rhinoplasty (9,094) and otoplasty (10,746). While teens account for a relatively small percentage of the 9 million people currently seeking cosmetic surgery, it represents an unprecedented growing trend, (a 5 percent increase since 2009), with a total of 125,397 individuals requesting body enhancements before they reach college age.
All surgery on anyone under 18 -- including cosmetic -- requires parental consent. The ASAPS advises teens against following fads, but it's up to parents to take responsibility for their child's physical and emotional readiness for cosmetic surgery. While most doctors carefully screen teens before surgery -- especially for repeat procedures -- they also tell parents that some may need "surgery to improve physical characteristics they feel are awkward or flawed," and that sometimes the "flaws, gone uncorrected, may affect them well into adulthood."
In a survey to determined future cosmetic trends, the ASAPS reported that this age group, between 18-24, is more likely than any other to consider plastic surgery -- now and in the future -- when compared to all other age categories. These findings suggests that if teens did not need parental consent (or their parents' funds), the numbers opting for surgery would likely be even higher.
And contrary to popular belief, it is not only America's youth who are lining up at surgeons' offices to improve their image before heading off to school. This trend has spread to China, Korea, Brazil and India. Reuters recently reported that in China, students in their teens and 20s made up 80 percent of the three million plastic surgery patients in Beijing this summer. One 21-year-old Chinese student from Shanxi spent 6000 yen ($940) to get her eyelids done before returning to school so that they looked larger and more Western. She told reporters, "I wanted to look and feel better about myself." China is second only to the United States in the number of plastic surgery procedures performed. And more individuals are choosing to have these procedures conducted at an earlier age.
Both here and abroad, it's sometimes the parents who encourage their teen get "work" done before heading off to school. Moms and dads who have had positive experiences with their own surgical procedures offer them as graduation gifts -- substitutes for traditional "care packages" that once awaited kids at their college dorm. One dad told me, "I was going to buy my daughter a car, like my father did when I graduated, but this will last her a lifetime." Parents say they just want to give their teens every possible advantage before heading off into the real world where the competition for good grades, jobs and even mates can be tough.
For students, entrance into college may seem the perfect time to start anew. One patient, about to begin her first year at an Ivy League school, told me she viewed college as an opportunity to make a fresh start -- socially and physically. She said, "In high school, I wasn't very popular. I waited until graduation to get my breasts done, so I didn't have to face questions from kids who I've known since first grade. I am looking forward to meeting new people with my new look." Another patient, a high school senior who up until now had resisted her parent's suggestion to get a nose job said, "I was getting nervous about going off to college and thought maybe they were right, a better nose might give me more confidence."
Although significantly more girls than boys request surgery, some procedures are catching on with male students. Some seek breast reduction (gynecomastia treatment). Others want their ears pinned back (otoplasty) or their nose reshaped (rhinoplasty). For these boys, it's largely about wanting to fit in. According to NYC plastic surgeon, Gerald Pitman, "The kids I see, their desire is almost uniformly to be normal, non-deviant. Kids don't want to stand out in a negative way." Interestingly, most adults who pursue surgery hope to look younger or better than others their age. Teens, on the other hand, want to look similar -- possibly a version of peer pressure taken to an extreme conclusion.
Both male and female teens talk about the practicalities of getting surgery during the summer between high school and college. The timing makes sense -- they don't have to explain their physical changes to former classmates and they can avoid calling attention to themselves. Some like the idea of getting liposuction in anticipation of the dreaded "freshmen 15." And while still living with parents who support them -- and their surgeries -- teens find it easier to justify these "medical" procedures being paid for by their families. Once out of school -- and on their own -- they know the cost of having these operations would be beyond their reach. Besides, it's nice to have a mom or dad available to help during the surgery and recovery.
So, why has plastic surgery become a "back to school" trend? Well, why not? The message our youth has grown up with is this: Not only do looks matter, but anything less than a perfectly beautiful face and body means you may be left behind. In spite of many advances forged by the women's movement, being pretty has once again been elevated as more important than almost anything else. (Did anyone else catch J.C. Penny's T-shirt that said, "I'm Too Pretty To Do Homework," before it was wisely pulled from the market?) Teens are surrounded by airbrushed actors, pop stars and celebrities -- many of whom discuss cosmetic procedures as a routine part of their grooming practices. Natural faces and bodies have essentially disappeared from the media -- and they just may disappear from our college campuses as well.
Teens and 20-somethings are spending their money (or their parents' money) to be nipped and tucked in an attempt to be prepared for school. Cosmetic procedures have become so mainstream that they are no longer reserved for only the rich and famous. These are everyday kids who, in the past, may have anticipated college as a time to figure out who they are and how to accept themselves. Now they opt for plastic surgery as part of their solution.
And who can blame them? This is what they believe will lead them to greater success. It's the parents -- and our culture -- who need to help them realize that the measurement that still matters most is the measurement of knowledge. There is more to being successful than obtaining physical perfection.
What do you think about the rising trend of teens opting for plastic surgery?
Vivian Diller, Ph.D. is a psychologist in private practice in New York City. She has written articles on beauty, aging, media, models and dancers. She serves as a consultant to companies promoting health, beauty and cosmetic products. "Face It: What Women Really Feel As Their Looks Change" (2010), written with Jill Muir-Sukenick, Ph.D. and edited by Michele Willens, is a psychological guide to help women deal with the emotions brought on by their changing appearances.