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‘Mom and Dad, I want to have bigger breasts’

"Today" contributor Dr. Gail Saltz offers advice to parents on how to tackle plastic surgery requests from their teenager.
/ Source: TODAY

For some teens, plastic surgery can have a positive impact on their physical and emotional development. But the idea of teens going under the knife can be a troubling scenario for some parents. Gail Saltz, an associate professor of psychiatry at The New York Presbyterian Hospital, was invited on the “Today” show to shed some light on the subject. 

Adolescence is often difficult. Your body and face are still part child, and yet your mind wants it to be all perfect and adult-looking. When you are unhappy with your appearance you may feel very pained or self conscious, you may even be teased and feel that you will be rejected as a result. It's hard to remember that your face and body are growing into themselves. Some parts grow faster than others, but in the end it will all even out. Unfortunately, an increasing number of teenagers are turning to plastic surgery as the solution. In today’s era of quick-fixes, avoiding any painful feelings, expecting perfection and idolizing outer beauty, preteens and teens are getting nose jobs, chin implants, liposuction and even breast implants.

The causes are multifactorialCertainly the infatuation with and attempt to be like young celebrities — along with the flourishing of television shows glamorizing plastic surgery procedures — has added to this trend. Girls feel they want to be, and now can be, like their idol. Weightier than this, I believe, is our increasing culture of extreme competition, the belief in perfectionism, the emphasis on physical beauty over inner beauty and the parent's difficulty in saying no. 

Many parents are still reliving their own memories of feeling rejected and being pained by their adolescent gawkiness, and they will do anything to spare their child that same pain. They are in a sense reliving those old and unprocessed memories through their child. As soon as their child says "I hate my nose, my ears, my chin" or "I'm so flat, I hate my thighs," some parents are ready to leap into action to stop those miserable feelings in their child and in their old memories. The message to their child is, "Yes, your nose is awful, your breasts aren't beautiful the way they are, you are physically unacceptable and that matters a lot."

It is very, very hard to see your child in pain. I don't want to minimize that. However, it is how you teach your child to handle discomfort, suffering and their own self-esteem that will put them in good stead for the rest of their lives. Another problem is that actions always speak louder than words. So when your child hears you complaining about your breasts, thighs and wrinkles, they see and believe that it is terrible to have a body with flaws. They identify with their parent's feeling that their imperfect body gives them low self-esteem. They want the same fix that mom has — botox and surgery.

Sometimes teens blame the moodiness of adolescence on their looks. Why? Because they don't know what is causing their bad mood and their appearance feels like something concrete they can blame it on. It's important to help them identify where their difficult feelings really come from. Sometimes extreme preoccupation with a body flaw or body shape can really be a sign of an eating disorder, and then that problem must be treated, not dealt with through plastic surgery, which will not resolve the issue.

I do want to distinguish the many very elective surgeries and procedures being done from surgery in extreme cases. In rare instances, for instance, a girl will have one breast develop and not the other. This kind of thing can have create a psychological trauma of its own, and this can have long-lasting detrimental effect. In this kind of case, plastic surgery can be psychologically the healthier thing to do. This means that parents and plastic surgeons must really decide on a case by case basis when surgery might be appropriate, and this means that parents and surgeons must be psychologically informed. The psychic trauma of recovering from surgery and the risks of things that may go wrong — both of which are often underrated — are important to consider as well before a teen goes under general anesthesia and the knife.

As a parent, there is a lot of pressure and desire to have your child excel. You can unwittingly increase their pressure to be competitively dysfunctional by encouraging their desire to be the most beautiful or have the perfect breasts. You can also increase their terror of aging by demonstrating that you feel aging is a horrible thing and that you hate your aging body.

So what can you do to help your teen when they are feeling unhappy with their appearance, which happens to 99 percent of teens at some point?

Share your storyNo doubt at some point you didn't like some part of yourself. Tell your teen that you really do understand how they feel because you have been there. Then really listen to their feelings so they don't feel alone. You should also explain to them how being a teen really is tough, but that they will continue to grow and change into who they will be. Explain that it is a bad idea to try to fix something that is both normal and still growing, that your issue changed and in hindsight you can see how important it is to wait.

Emphasize inner beauty and strength
Sadly, we are a looks-conscious society, and we forget to emphasize that who you are matters far more than what you look like. Never miss a chance to tell your child why you admire who they are.

Stick firmly to your beliefs
It's tough when your kid is going through growing pains — but stick firmly to your beliefs. You can tell your child that if they still want plastic surgery, they can have it when they are an adult. Tell them you believe it is a mistake because of the long-term consequences, and then help them to feel better about themselves as human beings.

Get your child some helpA teen who has a warped view of themselves or who has very low self-esteem is at risk for high-risk behaviors like alcohol use, drug use and promiscuity. They may need to see a therapist to get back on track. Some teens could be suffering from a delusional view of a body part, an eating disorder or depression, and their request for plastic surgery is actually a symptom of a problem. Help your teen find a good therapist with whom they can discuss their feelings and connect to.

Copyright ©2004 Dr. Gail Saltz. All rights reserved.