When Your Child Wants Cosmetic Surgery

When Your Child Wants Cosmetic Surgery

For most parents, the thought evokes an emotional response regardless of the reason why. We, as parents, so want to protect and encourage our children’s maturation on  physical, mental, and emotional levels. We pray their Body Image, defined as one’s subjective perception of themselves, is positive. In this day and time of social media, the pressures are intense and sometimes unrealistic and unhealthy. So what do you do when your child wants cosmetic surgery? The first step is to discuss your child’s concerns with them with empathy and objectivity.

Over the past near 20 years, we have seen a gradual but distinct increase in the number of procedures performed on children (defined as less than 18 years of age). The increase is likely due to access, education/awareness, and a lessening that it is a taboo subject of  yester-years. The most common procedures are: (1) Rhinoplasty (reshaping of the nose) for elective and post-trauma deformities. With kids participating in very competitive athletics at an earlier age, the majority of these are secondary to post-trauma deviations, formation of dorsal humps, or airway compromises. Some are simply genetics and the child is sick of being joked upon that they got Grandpa Ron’s nose. Once the nose has completed growth in early puberty, the elective and/or post-trauma corrections can more predictably be addressed. The nose is the most prominent and vulnerable anatomical feature and consequently suffers the highest frequency of trauma. Actually, sometimes the family will have no distinct recollection of trauma but a CT scan shows evidence associated with the feature the child was displeased with. (2) Otoplasty (reshaping /’pinning’ of ears or reshaping post gauge placement or trauma distortion of the earlobe). The average age is approximately 8 with some advocating for earlier operation for obvious congenital (present at birth) deformities. (3) Correction of jaw deformities or facial imbalance with orthognathic/Jaw Surgery or the strategic use of facial implants once growth is complete. The most severe of deformities are craniofacial syndromes or clefts that need secondary surgeries once growth has completed. (4) Breast Reduction for premature and exaggerated breast development resulting in ptotic(drooping) heavy breasts. (5) Breast augmentation to address major asymmetries. Severe asymmetries are defined by the completion of puberty and usually can be improved by a simple compensating breast augmentation. (6) Gynecomastia reduction of breast tissue on teenage boys that have seen an asymmetric or exaggerated formation of breast tissue thru the hormonal changes of puberty. (7) Laser Resurfacing to improve the resultant topographical scar deformities from significant acne, chicken pox, or trauma (8) Scar revisions from previous surgeries or trauma.


Regardless of what kind of surgery is potentially indicated, the motivating factor tends to be a desire for improved self-esteem for the child or teen. It is important to discuss the impact of teasing and ridicule by their peers on them emotionally, objectively assess the magnitude of the perceived ‘flaw’, understand the child’s/teen’s expectations and goals, consult with a caring surgeon that can manage expectations on both an emotional and physical level, and then make a family supported decision. Children with emotional or psychiatric troubles should first address such with assistance from their pediatrician, primary care or psychiatric professionals. As surgeons and parents, we take a great deal of pride and responsibility to care for our pediatric and adolescents on emotional and physical levels and are committed to doing so in a safe, responsible manner.

To discuss with a cosmetic surgery professional, call Austin Cosmetic Surgery at (512) 688-8000 for a consultation.

Dr. Michelle Carlotti

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