The Risks and Alternatives of Cosmetic Surgery for Adolescents

Cosmetic surgery for adolescents: To prevent it from becoming a knife that cuts off growth, doctors must disclose the risks and alternatives.

Hello,

This is Dr. J from Cheongdam SNU Plastic Surgery Clinic.

‘I heard that parental consent is all that's needed!’

When a 14-year-old girl requested lower eyelid fat repositioning surgery,

I refused her request,

pointing to her immature cheekbones.

Cosmetic surgery for adolescents whose skeletal growth is not yet complete

can be the beginning of lifelong

deformities.

# The Current State of Adolescent Cosmetic Surgery: Alarming Statistics and Spreading Background

⚠️ The adolescent surgery craze that swells every vacation

Every winter vacation, plastic surgery clinics are

overflowing with adolescents.

Individuals in their teens and twenties account for over 60%

of all cosmetic surgery patients,

with double eyelid surgery (50%) and nose surgery (30%)

being the most popular procedures.

One survey even found that 15% of middle school students

have actually undergone surgery.

⚠️ The dangerous misconception that ‘the second year of high school is the right time’

In a survey of high school students in Seoul,

65% reported appearance complexes,

and over 50% expressed a desire for plastic surgery.

Furthermore, the perception that ‘the second year of high school is the peak time for surgery’

is widespread, with students anticipating employment and college entrance exams

opting for proactive surgery.

⚠️ The collusion of marketing and lookism

Exaggerated plastic surgery advertisements targeting adolescents

are rampant on bus and subway ads (56.8%), social media (24.5%), etc.

30.4% choose a clinic based solely on these ads,

and information about side effects is mostly omitted.

# Physical Risks: The Three Major Risks That Damage Growth

⚠️ Skeletal deformation and malformation

In the case of nose surgery,

if performed before the age of 18, the pressure from implants

can cause deviation and depression.

Jaw surgery can

cause damage to tooth roots,

and facial contouring surgery can

lead to abnormal bone growth.

For lower eyelid fat repositioning,

if performed at age 14 when cheekbone development is not complete,

there is a more than 70% chance that the repositioned fat will sag or become asymmetrical

as the bone continues to grow.

⚠️ Complications due to immature recovery

Adolescents have weaker immune systems than adults,

doubling the risk of infection, necrosis, and nerve damage.

Among actual side effect cases,

asymmetry (9.4%), scarring (5.7%),

and inflammation (3.6%) are the most frequent.

⚠️ The vicious cycle of repeated plastic surgery

Surgery performed during growth can lead to additional surgeries

due to changes in body shape.

Even adult plastic surgery results often only last

5-7 years,

meaning early recipients may undergo surgery

2-3 more times throughout their lives.

# Mental Storm: When Surgery Becomes a Psychological Wound

📍 The illusion that ‘life will change if I become prettier’

72.5% of teenagers cite ‘simple appearance improvement’

as their motivation for surgery, but their satisfaction is

significantly lower than that of patients over 20.

Especially for surgeries aimed at resolving bullying or for employment purposes,

when expectations are frustrated, it can lead to depression and suicidal ideation.

📍 The trap of Body Dysmorphic Disorder

Adolescents with strong appearance obsession continue to demand

further procedures after surgery, saying ‘it’s still not enough.’

According to research by Seoul National University Hospital, these individuals

show delusional dissatisfaction even with normal appearance

and experience paralysis of life functions.

‘After the surgery, I felt more lethargic. Before, I thought I only needed to fix my nose, but now my jaw and cheekbones keep bothering me.’ – From an interview with a female high school senior after jaw surgery.

# Legal and Ethical Issues: Consent is not ‘Permission’.

📍 Limitations of parental consent

Under medical law, minors can undergo surgery

with parental consent.

However, doctors have a duty to determine the patient's best interests. Countries like Germany and Italy

completely prohibit cosmetic surgery for those under 18,

and while a related bill was discussed in Korea in 2013,

it was postponed due to a lack of medical evidence.

📍 The social responsibility of doctors

We should ask ‘what surgery should be done’ rather than

‘what surgery can be done.’

The Association of Plastic Surgeons points out that ‘adolescent surgery is primarily caused by an oversupply of clinics

rather than patient demand,’

and there is a heated debate within the medical community

regarding age restrictions.

# Three Approaches That Should Precede Plastic Surgery

🌟 1-year grace period strategy + non-surgical management

Lifestyle correction methods include

increasing water intake,

reducing smartphone usage,

and using makeup to

alleviate dark circles.

Temporary adjustment methods include

using double eyelid tape and makeup.

🌟 Mental health support system

Pre-surgical psychiatric consultation and evaluation are needed

to screen for body dysmorphic disorder and depression.

Additionally, there are programs for redefining aesthetic consciousness,

such as ‘finding inner beauty’ workshops

and education on the diversity of celebrity vs. real faces.

🌟 Checklist for minimum surgery conditions

✅ Complete skeletal growth (confirmed by bone age test)✅ Problem persistent for 6 months or more + failure of conservative treatment checked✅ Patient can explain the purpose and risks of surgery themselves✅ Written confirmation of alignment between parent's and patient's expectations