"Unless there is a very serious pathology such as an accident or genetic condition that led to disfigurement, cosmetic procedures should not be done on someone under 16 or 17," says Daniel Callahan, Ph.D., director of international programs at The Hastings Center, Garrison, N.Y.
Cutting through cultural influencesIn a society that places significant emphasis on young women's appearances, he adds, "One of the jobs of the responsible physician is finding a way to cut through that cultural influence and see to what extent the child might have a distorted notion of how one should look."
In such cases, she says, "The mother knows what the mother wants, but the 16-year-old isn't emotionally mature enough yet to know exactly what she wants."
"There is a statistically small, but growing number of procedures (being done) for minors," especially in Japan, where teenage breast enhancement made headlines during the mid-1990s, says Sander Gilman, Ph.D., distinguished professor of liberal arts and sciences, Emory University. "I don't believe it's done any less frequently" since then, he adds.
Dr. Carruthers says that in North America, "I'm sure it happens" that surgeons occasionally perform breast enhancements on minors. However, she notes, "The breasts haven't finished developing often until a girl is in her 20s. So if one does a breast enhancement for a 15- or 16-year-old girl, who's to know she won't need a breast reduction later?"
Older is wiser
Regarding older patients, Dr. Callahan says that if the patient's reasons for wanting cosmetic treatment make sense and the patient is otherwise healthy, "age is irrelevant."
In seniors, Dr. Carruthers says, "The real concern is that the treatment may not be as effective as they would like, because there may be quite a lot of sun damage to their skin. Or, they may actually need more surgery than one feels is safe for them to achieve their goals."
Dr. Gilman says, "The argument against cosmetic surgery always is that it simply has to do with individual vanity. That's a moral judgment by people who don't like the notion of a procedure, an age or surgery in general. One man's vanity is another man's necessity."