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Generation of teens clamors for plastic surgery Doctors must grapple with ethical questions


NEW YORK -- Standing in front of the full-length mirror, the girl fights back tears. Her thighs are too big, her breasts too small and her nose bumpy. Or so this 16-year-old thinks, comparing herself with "Baywatch" babes and Victoria's Secret models.

To make matters worse, boys never call, and getting undressed for gym is a mortification. But such problems have quick fixes, the magazine ads promise.

"If I can look better, why not?" the girl asked during a recent consultation with a plastic surgeon. Her parents are living proof, she argued, her mother rejuvenated by a face lift and her father's brow smoothed of its furrows.

The doctor was not persuaded. He said later that he had stalled by scheduling another appointment, and that he hoped the Long Island family did not look elsewhere in the meantime.

Teen-age girls flocking to the suites of plastic surgeons from Park Avenue to Beverly Hills pose an ethical problem for doctors who must decide whether to operate on patients too young to vote but old enough to feel social pressures to be physically perfect.

"We are capable of doing awful things to these kids," said Dr. Mark Sultan, chief of plastic surgery at Beth Israel Medical Center and one of two dozen doctors who said they are seeing more teen-agers than ever before who are eager to change their looks and willing to go through often painful surgery to do so.

At least 14,000 adolescents nationwide had cosmetic surgery in 1996, a slight increase from 1992, when the boom began, according to data from the American Society of Plastic and Reconstructive Surgeons. In all age groups, 700,000 procedures were done last year, up 70 percent in four years.

Professionals agree that those numbers are a vast understatement, perhaps by as much as half, since they do not include the many procedures done by dermatologists, ophthalmologists, ear, nose and throat specialists, dentists and others.

The makeovers of choice are changing for teen-agers. A generation ago, it was not unusual for youngsters to have their noses straightened or ears pinned back, procedures that doctors say are appropriate for those with ungainly features.

These days, other procedures -- breast augmentation, liposuction and tummy tucks -- are gaining popularity in this age group.

In 1992, 5,519 nose jobs were reported among teen-agers, 3,024 ear operations, 978 breast implants, 472 liposuctions and no tummy tucks. Four years later, nose jobs were down to 4,313 and ear pinnings to 2,470.

Breast augmentations were up to 1,172, liposuctions increased to 788 and tummy tucks to 130. Many more adolescents seeking these newer procedures were turned away by doctors who say they rarely perform them in anyone under 18.

Dr. Christopher Nanni, for one, set out to dissuade an overweight girl who came to him recently after many failed attempts at diet and exercise. She was 16 years old and 5 feet 3 inches tall, and weighed 185 pounds.

Her mother, divorced and struggling on a secretary's salary, was not enthusiastic about the costs or the risks of liposuction.

Nanni put the girl on a sensible diet and encouraged her mother to buy a treadmill. Come back in a year or two, he told them. If jTC liposuction seemed appropriate then, he would do the procedure, at a big discount.

Pub Date: 12/27/98

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