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updated 3/30/2010 4:34:06 PM ET 2010-03-30T20:34:06

Teens can be mean. Just ask Jen Selter, Jon Escalante and Hannah Olson.

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For years, Selter endured taunts because of her nose size. Kids ridiculed her by saying she looked like a pelican and by calling her “butter face” — code for “She’s hot, but her face!”

Escalante deliberately grew his hair out to hide ears that had branded him with the nickname “Dumbo.” And Olson’s self-confidence flagged as she tolerated “horrifying” name-calling after developing DDD-size breasts as a teen.

In a world where people of all ages increasingly turn to plastic surgery for reasons that are purely cosmetic — and, in some cases, narcissistic — Selter, Escalante and Olson said they opted to go under the knife as teenagers for different reasons. It wasn’t something they did solely because of the relentless name-calling. It also had a whole lot to do with how they felt about themselves on a deeper level.

“My advice to teenagers is don’t have a nose job just ‘cause you’re worried about what other people say or think,” said Selter, who had rhinoplasty done last summer at age 15. “It all has to do with how you feel on the inside. And getting a nose job made me feel good inside and out.”

Like ‘braces for crooked teeth’?
To be sure, the very notion of doing any kind of plastic surgery on teenagers raises concerns for many parents and health professionals — and there are valid reasons for concern.

“Mom and Dad, please be sure your adolescent or your teen is aware that this is not a coping skill — that every time we feel uncomfortable about ourselves, then we go out and we get surgery,” psychiatrist Charles Sophy told TODAY. “Because that’s how we begin a huge line of problems.”

Reputable cosmetic surgeons with teen patients typically recommend a series of at least four sessions with a therapist before moving forward with any procedures. The point of these sessions is to uncover underlying motives for wanting surgery, as well as to determine the emotional maturity of the patient.

Such precautionary steps are important because demand is on the rise. Although just two percent of all plastic surgeries are performed on teens, the number of teens getting plastic surgery has doubled since 2002, according to the American Society of Plastic Surgeons. Nose reshaping, ear reshaping, acne and acne-scar treatment, breast augmentation and breast reduction are popular procedures among teenage patients.

Generally speaking, plastic surgeons report that many teens want plastic surgery because they long to fit in with their friends, while many adults pursue plastic surgery because they want to stand out.

But when a teen seeks out plastic surgery to correct a noticeable physical defect or to change a body part that’s caused prolonged psychological distress, that can be a good thing, doctors say.

“It’s no different than kids getting braces for crooked teeth,” said Dr. Sam Rizk, Selter’s plastic surgeon.

Dr. Nancy Snyderman, NBC’s chief medical editor, agreed that plastic surgery can be altogether positive in the right circumstances. In the cases of Selter, Escalante and Olson — all of whom were featured in Friday’s edition of People magazine and interviewed on TODAY on Tuesday — Snyderman thought they made responsible choices when they decided to have plastic surgery done at ages 15, 17 and 19.

“Remember we’re not looking at 10- and 11-year-olds,” Snyderman said. “We’re looking at young adults who were part of the decision-making process, and that plays a big role. ... You’re looking at three very appropriate cases for wanting to change things.”

How young is too young?
Before moving ahead with any kind of plastic surgery, parents and teens are encouraged to remember that surgeries are never risk-free. They should read up about any possible complications and be sure they can handle the risks involved. A real awareness of the risks can prompt parents and children to pursue non-surgical options for changing body image, such as diet and exercise.

Parents and children also should be aware that guidelines do exist for younger patients. Facial plastic surgery generally should not be done on anyone until facial growth is complete. For a female, that happens by about age 14; for a male, it’s about age 15.

The U.S. Food and Drug Administration will not allow breast augmentation to be done on anyone younger than 18, and most surgeons will refuse to perform liposuction on anyone younger than 17 or 18.

(Generally speaking, it can be wise to choose a surgeon who has experience working with younger patients. Be sure to check the surgeon’s complaint history.)

For their parts, Escalante, Olson and Selter all told TODAY that they have no regrets about their plastic surgeries. Escalante’s decision to have his ears pinned back made him feel good about cutting his hair to pursue his dream of becoming a firefighter. Olson’s breast-reduction surgery gave her relief from pain and made it possible to maintain an active, athletic lifestyle. And Selter’s nose job made her more confident and carefree.

“Jen is so happy now,” said Selter’s mother, Jill Weinstein. “I would say to parents ... it’s the greatest gift you could give to your child. What greater gift is confidence and to help them feel happy in who they are?”

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