MORE THAN 200,000 TEENS HAD PLASTIC SURGERY LAST YEAR: AND THE CULPRIT IS ... SOCIAL MEDIA

For many years now, a popular high school graduation gift has been a nose job or otoplasty (ear pinning). In more recent times, that evolved into breast implants. Since the inception of Instagram in 2010, plastic surgery has seen an enormous rise in teens requesting lip fillers, Botox, and buttock augmentation.  Teens seeking to morph into someone else is fueled by studies that show that “The average millennial takes over 25,000 selfies in his or her lifetime, which is astronomical and one of the major reasons for the self-esteem issues in this age group.” More than 40% of surgeons in a recent American Academy of Facial Plastic and Reconstructive Surgery survey said looking better in selfies on Instagram, Snapchat, and Facebook was an incentive for patients of all ages undergoing surgery.  Dr. Manish Shah is a Denver board certified plastic surgeon. He wants to help teens, and parents of teens navigate this world of teens and plastic surgery to discuss what is appropriate and at what age in a culture where it can seem as if everyone is having something done.  He understands this quandary as he is not only a plastic surgeon but a father of 3 teenagers.

Breast reduction

Some teens suffer from Juvenile Breast Hypertrophy. This often results in teasing, name calling, difficulty with exercise and clothing selection. It is reasonable to perform breast reduction surgery on these girls after the age of 16. This procedure is performed under general anesthesia and the breast tissue is sent off for pathological evaluation. Recovery tends to be less than two weeks with minimal overall risks.

Otoplasty (ear pinning)

Kids get teased for having "Dumbo ears" quite routinely. We become aware of the "other" in our lives after the age of 6. Otoplasty can be done at any age after 6. It is a safe surgery that can be easily performed in the office under local anesthesia.

Rhinoplasty

There are few things a teen can do to hide a nose that they are not happy with or get teased about. Teens can have rhinoplasty surgery, but only after their faces have completed growing. For girls that can be as young as 14 years old, and for boys, it is typically around 17 years old. Often, teens have additional problems with nasal obstruction from trauma as kids. This can be fixed at the same time as the cosmetic surgery. Insurance will often cover the medical portion of the surgery, but the cosmetic portion is usually an out of the pocket expense.

Liposuction

Liposuction for teens is not a common procedure. For most teens, they can achieve healthy bodies via proper diet and exercise. Frankly, this is better for them. After 15 years of practice, I can say that I have never performed liposuction on anyone younger than 18 years old.

Butt Implants-

Butt implants are not a procedure that teens have performed. I reserve this procedure for patients older than 22 years old who have failed exercise as a method for gluteal muscle enlargement and are not candidates for a fat transfer to the butt (Brazilian Butt Lift).

Breast Implants-

The American Society of Plastic Surgeons recommends that breast implants, especially silicone implants, not be used in patients less than 22 years of age. This is primarily for reasons of patient maturity and possible early family planning. In my practice this has been the case typically; however, I have placed silicone implants in patients as young as 18 years of age because they were financially independent, mature, and already had children of their own.

Botox in the Forehead and Crow’s Feet

With today's access to technology, everyone is squinting to look at tiny screens. Over time, this increases complaints of eyestrain, headaches, and wrinkles. I think neurotoxin can be injected for patients as early as 18 years old, and earlier if treating for migraines. I started injecting my youngest daughter when she was 16 years old because of migraines. The treatment has helped her tremendously.

Chin Implant

Chin implant surgery can be performed in teens after their faces have finished growing. It is a procedure that is often combined with rhinoplasty, and/or chin liposuction to create a better jawline in those whose jaws are underdeveloped. If a patient is not a candidate for jaw surgery by their dental surgeons, they often seek out plastic surgeons for this combination of procedures.

Lip Fillers-

Lip fillers are not really something I perform in those younger than 18 years old. There isn't a significant justification for lip augmentation in this population. After they turn 18 years old and are legally adults, then I have no problem injecting filler as the risks are better understood at this age.

Lasers

Lasers for teens are common in two particular scenarios: laser resurfacing for acne scar reduction and laser hair removal. Since teenage acne is ubiquitous, scarring is the big problem afterward. Once teens get their acne under control with the help of a dermatologist, they can undergo laser treatment to soften the scars and reduce pigment. When excess facial or body hair is a source of emotional distress for a teen, laser hair removal treatments can be used to reduce the problem. Both procedures can be performed after the age of 16 years old with parental support and consent.

Filler in the Cheeks-

I don't recommend that teens get fillers unless it is to balance off major facial asymmetries.

What makes some teens ready for cosmetic surgery and why would you turn away others?

For a teen to be ready for cosmetic surgery, it is necessary that they have family support, both emotionally and financially. They need to display a level of maturity that shows that they have done their research and understand the pros and cons of having a particular procedure. When I turn a teen away, it is most often because they clearly don't exhibit a level of maturity, understanding, and rationality necessary to make a good decision for themselves. Their ability to consent to treatment is impaired. Often, there is a power struggle between the teen and the parent that clues me into the fact that they are not ready for surgery.

Are there specific procedures you just won't’ do under a certain chronological age, and if so, which procedures are they?

Honestly, most of the body procedures are off limits in my practice until the patient is at least 18 years old. I will perform breast surgery on patients with congenital breast deformities before the age of 22 years old. However, routine cosmetic breast surgery can wait until the patients are more mature. Outside of rhinoplasty and chin implant surgery, most facial procedures aren't appropriate before a patient is in their twenties.

In summary, Dr. Shah feels strongly that, “Parents need to have frequent conversations with teens who seem obsessed with selfies and plastic surgery. Adolescents must understand that their idols like Gigi and Bella Hadid, The Kardashians, Cardi B, and others make their living off their face and bodies. They represent only 1 % of the population.  Parents must stress that while looks do count, so too do brains, ambition, personality, good choices, and talent. In general, the bulk of cosmetic surgery should be reserved for adults who are fully actualized people and want to make tweaks with realistic expectations and motives.”

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A PLASTIC SURGEON UNVEILS BEAUTY HACKS THAT WILL COST YOU LESS THAN A STARBUCKS COFFEE

We all know that cosmetic-plastic surgeons and dermatologists earn their living by operating or non- invasive procedures. Most of these endeavors are costly for patients. It’s rare that any aesthetic surgeon will let us in on things we can do daily that don’t require us to visit them! We are fortunate to have Dr. Manish Shah, a Denver board -certified plastic surgeon share secrets with us, that in many cases cost nothing or less than a gourmet cup of coffee.

DR. MANISH SHAH’S TOP BEAUTY HACKS

1. Cleaning your phone screens – Dr. Shah offers that, “A great way to avoid blemishes is to routinely clean the makeup and bacteria off of your phone screens. It is easy to spread harmful skin bacteria from the surface of your phone. Washing your hands goes a long way to avoid skin contamination as well.”

2. Make your own exfoliating scrub at home – Dr. Shah shares that, “A woman I consider my second mother taught me how to create my own organic exfoliating scrub. She would dry peeled skins of oranges, lemons, and limes in the sun. She would then finely grate the white inside rind of the peel and then mix it with any facial cleanser or even add it to fine facial oils. Using the scrub would exfoliate the skin, treat it with Vitamin C, and prevent over-drying of the skin because of the fruit oils.”

3. I recommend treating the enlarged pores of the T-zone with over the counter hydrogen peroxide. The bacteria in the pores create inflammation that increases pore size, and this leads to blackheads and whiteheads. Dr. Shah explains that, “These bacteria can’t survive in high oxygen environments. 3% hydrogen peroxide is available over the counter quite inexpensively. Treating only the T-zone at night kills the bacteria, reduces pore size and blemishes. Because it can be quite drying, takes breaks from its use every now and then.”

4. Avoid fake nails. They harbor tons of bacteria that are easily transferred to the face when you touch your face. Instead, focus on growing your own nails with the help of oral vitamin C and any good quality hair, skin, and nails vitamin like Nature’s Bounty Extra Strength Hair, Skin, and Nails.

5. For teens, especially, it is so important to wash their pillow cases routinely. Dr. Shah is the father of three teens. From his first-hand knowledge he says that, “Teens aren’t very compliant when it comes to skincare and they suffer from hormones in a bad way. This 1-2 punch makes acne and blemishes the bane of most teens’ existences. Going to sleep at night on clean pillow cases after washing your face goes a long way to reducing bacterial burden and allows blemishes to heal.”

6. If you suffer from puffiness around the eyes, a quick trick is to use black tea bags. Wet them in ice water and lay them onto the eyes to soothe. The caffeine in the black tea causes blood vessels to constrict, reducing edema or swelling in the delicate, thin eyelid tissues.

7. Add baking soda to your toothpaste to easily polish away stains to keep your teeth white. Instead of bleaching your teeth, baking soda actually breaks the molecules that stain the teeth. It is less irritating to your gums as well, and way cheaper than teeth whitening strips.

8. Eat the rainbow - A white bread-based diet does not for clear skin make. That’s why Dr. Shah makes sure his diet is packed with brightly-colored fruits and vegetables. He says, “Fruits and vegetables are high in antioxidants which give glow to the skin.” Specifically, research suggests that pigments called carotenoids—found in foods like carrots, spinach and other leafy greens, and tomatoes have been linked to good complexions.” Adding fish oil to your diet also improves skin compliance and radiance.

9. Avoid Hot Showers - Disappointing as it may be, Dr. Shah says, “Hot showers remove too much of your natural oils and brings blood circulation to your skin, creating inflammatory reactions that result in rashes and aggravate those with eczema or dry patches.”

10. You may just need a brow wax instead of a lift

“I had a patient who wanted a brow lift because she thought she looked angry all the time. I sent her for a brow wax instead. It took 15 minutes, she looked great, and she saved herself thousands.” Other brow techniques like brow tinting can change how your eyebrows frame the eyes, improving on your looks.

About Dr. Manish Shah

Manish Shah, M.D., F.A.C.S. is board-certified by the American Board of Plastic Surgery and member of the American Society of Plastic Surgeons, the American Society of Aesthetic Plastic Surgery, the International Society of Aesthetic Plastic Surgery, the Rhinoplasty Society, and the European Academy of Facial Plastic Surgery. After completing his formal plastic surgery training in Plastic and Reconstructive Surgery at the Univ. of Tennessee College of Medicine, he moved to New York City and was selected for the prestigious Aesthetic Surgery Fellowship at Manhattan Eye, Ear, and Throat Hospital. He underwent extensive, advanced training in aesthetic surgery of the face, breasts, and body at the hands of some of the most renowned cosmetic surgeons in the world. Dr. Shah is one of only a select few plastic surgeons in the country who have undergone formal post-graduate training in aesthetic surgery.

Dr. Shah’s specialties include revision facial aesthetic surgery, rhinoplasty (“nose reshaping”), and aesthetic surgery of the breast (breast augmentation, breast lift, breast reduction). He is, however, well-trained in all areas of aesthetic surgery. Dr. Shah’s aim is to obtain a natural appearing transformation that complements the real you!

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