Adolescent Aesthetics and Timing of the Surgery

The application of a procedure at the most appropriate time is one of the indications whether it is done correctly or not.

For example, there are both corrective (anatomical) and protective (socio-psychological) reason why we perform prominent ear surgeries while the child is at the ages of 5-6.  On the one hand, by having the surgery before the school time, we prevent a probable situation in which the child could be ridiculed by his friend. On the other hand, we want to perform the operation in this most appropriate time with the knowledge that 80-85% of the ear takes its final form in this period.

Nevertheless, in some congenital anomalies such as “hypospadias”, where the urination point is placed in an abnormal location, or “syndactyly”, in which the fingers of the baby are stuck together, and the timing of the surgery is obvious and it affects the result as much as the technique to be applied.

Adolescence is a time when ordinary situations are considered very important and emotions are overflown. During this period where socialization, identification, emulation, role-modeling, and the need to manifest the personality are at the peak, insistence and obsession get energy and logistical support from hormones that hit the peak.

I do not consider the aging or the expectations of the people, who consult me, as diseases. I see and describe them as situations where the whole is left incomplete and hence which should be completed and which are often psychosocial and bio-psycho-social cases. For these reasons, the timing of surgery or interventions is very important and critical.

In this regard, one of the most important factors that could guide us in making the right decision is the completion of the physical development of the patient.  While timing is bad if you are going to make an aquiline nose surgery for a 15 years old, the situation could be quite different for a gigantomastide (giant breast) surgery at this age, This situation, which is characterized by overgrowth of the breasts, gives a lot of discomfort to the patient, that she had difficulty in sleeping, walking,  and even studying. This socio-psychological discontentment accompanied by physical problems gives rise to a scientific, ethical and aesthetic justification. Hence such a surgery could be performed for a patient who is at the age of 15.

Breast reduction surgeries, fat removal with liposuction and abdomen lifting operations (Abdominoplasty) should be evaluated with the same logic. Enlargement of breasts in adolescent males (Gynecomasty) is considered a provisional physiological and natural situation and it should not be operated. The applications that can be made under adolescent aesthetics should be limited to correction of prominent ears, low eyelid (ptosis), regional hair strengthening techniques, other laser applications, including hair removal, skin stain treatments, eyebrow shaping, acne and scar treatment, orthodontic treatments, limited filler applications  and rarely botulinum toxin injections.

In this period, we often observe acts of scarring over the body, especially arms, nail biting, hair pulling (trichotillomania), excessive piercing, as reflections of search for relief form unavoidable distress caused by uncontrolled intense emotional energy. In this respect, the parents should not present them with an aesthetic surgery (such as breast enlargement, rhinoplasty, liposuction for weight loss etc.) as a present for passing a grade or graduation with the hope of substituting children’s tendency to damage themselves.

The other parameters to be taken into account while determining the best timing for an aesthetic operation or surgery are as follows: psychological stability and well-being of the patient, general health condition, mental health,  existence of cancer, usage of drugs, breasts-feeding, pregnancy and hormone levels preventing the possibility of surgery.