As a plastic surgeon, I see young women come to my office for a variety of reasons – most often, they are curious or looking for breast reduction, breast augmentation and chin liposuction. While this may come as a shock to some, the truth is that we’ve all experienced things about our bodies that we don’t like. It’s practically a puberty rite of passage. I’m not sure I know anyone who hasn’t used braces or Invisalign to straighten their teeth, for example.
But now, teens and young adults are seeking more invasive treatments — high-end skin care products, laser treatments, lip fillers and even plastic surgery — that can leave parents feeling confused. It is known that body image concerns are often ubiquitous during adolescence and can have a negative impact on mental health. Exposure to social media, celebrity influence and the use of image filters have led to more young adults chasing (often unrealistic) standards of beauty, and they have also become more aware of cosmetic procedures to help them achieve their goals.
While there are some young men who undergo cosmetic plastic surgery procedures, the majority of these patients are young women. According to American Society of Plastic Surgeons 2023 Plastic Surgery Statisticsthe five most common surgeries for patients aged 18-19 were breast reduction, rhinoplasty (nose implants), liposuction, gynecomastia surgery (male breast reduction) and breast augmentation.
When they come to my office, young women have varying degrees of knowledge about the procedures for which they seek consultation. Some come to the decision to see me for a consultation after researching something that is bothering them. Others learn about the procedures through celebrities and influencers who share their experiences or from other social media content. And then there are those who seek a consultation at the suggestion of their mother and know very little before the consultation.
No matter how a young woman gets to a plastic surgery appointment, I think it’s helpful for her to bring a parent, friend, or someone who will help care for her after surgery to that initial office visit. Just as most of these teenage patients are young women, the parent most often included in these conversations is the mom, especially since many of these young women are considering breast surgery.
In my practice in particular, I meet many moms—including those who have had cosmetic surgery themselves—who are increasingly challenged with navigating these conversations with their daughters. Often, they try to promote self-acceptance while supporting their daughters’ decisions to surgically address something that bothers them. Since I see these conversations happening all the time, here are the issues I encourage moms to consider when having these conversations with their daughters.
Consider age and emotional maturity
During adolescence, young adults experience growth spurts and major changes in their bodies. It usually doesn’t make sense to perform elective surgery on a body part that is still in transition. However, I think it makes sense for moms to have conversations with their daughters at this time about the changes these young women are experiencing in their bodies and any aspects of their bodies that they are unhappy with. It may also be helpful to engage in these discussions with a pediatrician, gynecologist, or plastic surgeon. If the daughter seems distressed about her body in a way that is out of proportion to what might be considered the norm, talking with a mental health professional is helpful.
When young adults consider surgery, it’s also an opportunity to teach them about physical autonomy and being health advocates.
When young adults consider surgery, it’s also an opportunity to teach them about physical autonomy and being health advocates. This is a marked departure from having the child dragged to the doctor’s office by a parent and not participating in any of the discussions or decision-making. Some things parents should consider when assessing their teen’s emotional maturity include self-awareness. impulse control; coping mechanisms for change, stress, frustration and challenges. ability to set realistic goals and develop plans to work toward them; and accountability.
A young adult who is not yet emotionally mature enough to participate in his own health care and who cannot cope with the changes that occur while healing from surgery is not, in my opinion, emotionally mature enough to undergo elective surgery. cosmetic surgery.
Understand the risks, potential complications and long-term effects
For any young woman undergoing a procedure, she must consider whether the benefits of the procedure outweigh the potential complications. She also needs to understand her unique risk of complications, which varies based on factors such as underlying health conditions and anatomy.
When I see young women being consulted for breast reduction, for example, we discuss the implications of breast reduction before pregnancy, including the potential impact of the surgery on future breastfeeding and how breasts can change with the weight changes that occur with pregnancy. Breast reduction before pregnancy often means another breast surgery (breast reduction or breast lift) to address breast changes after pregnancy-related breast changes.
I regularly tell young women that there is no right or wrong choice, but only they can decide what is most important to them. They can experience breast problems (back pain, difficulty finding bras and clothes that fit well, body insecurities) before pregnancy and may need to have another breast surgery in the future or they can wait until after pregnancy to have a breast reduction and minimize the chance of needing another breast surgery.
Consider reversibility and alternatives
As someone who was a precocious teenager, I was always pretty sure I knew what I wanted. Time has often proved me wrong. I now advise moms to encourage their daughters to take baby steps and start with less invasive and less permanent treatments before moving on to surgery when appropriate. For example, depending on what is bothering a young woman about her nose, a liquid rhinoplasty with fillers can give her an idea of what her nose would look like before undergoing rhinoplasty surgery.
In my experience, moms in particular seem more open to supporting their daughters’ choices about reversible procedures. Lip fillers are a great example of this. Celebrity influencers are increasingly getting lip fillers, which in recent years has sparked a lot of interest among young women. Since the filler can dissolve, many moms were more comfortable with their daughters going ahead with it.
Use this as an opportunity for important conversations
Another important aspect of these discussions is the cost of the procedure and who will pay for it. I usually see procedures “given” as birthday or graduation gifts, but paying for a procedure herself could make a young woman more committed and literally invested in the decision and the procedure.
I also think these conversations can be a tantalizing experience and moment of openness for moms to share with their daughters the body insecurities they’ve had and what they did or didn’t do to deal with them—including acceptance, treatment, and surgery – and what they are glad or regret that they did.
As women, we need to acknowledge the anxiety many of us have around body ideals and normalize transparent conversations about not only how we feel but what we do to deal with how we feel. During these discussions, it is extremely important to ensure that both parties feel heard and respected, and that there is a genuine effort to understand the other’s perspective. By exploring these things together, moms and daughters can forge a stronger bond and create community with other women who share these experiences.
Aisha White, MD, is a board-certified plastic surgeon in Austin, Texas. She is passionate about educating girls and women about their bodies and health care choices and body empowerment. promote and support diversity in the beauty industry (including ethnic diversity, size inclusion and age inclusion); and promote awareness and facilitate conversations around the intersection of mental health issues, unrealistic beauty standards and plastic surgery. Dr. White has appeared in numerous scientific journals and is published for her research and work related to reconstructive plastic surgery.
