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A Cap and Gown--and New Breasts

Trends: In time for high school graduation, more teens are getting implants. Surgery on the young stirs controversy.


Driven by vanity, self-esteem issues and society's fascination with breasts, teenagers are having implant surgery in increasing numbers, especially in affluent areas of California and other Sunbelt states.

Some high school students have returned from spring break with a new bust line in time for the prom. Others are receiving breast enlargements as graduation gifts from their parents.

Older teenagers are using inheritances, loans or their savings to pay for what nature didn't provide.

This month a Huntington Beach high school senior--tall, pretty and with a perfect smile--is debating which college to attend. Next month the 18-year-old, who did not want her named used, will spend $5,000 of her savings on the surgery.

"It is to make me feel better about myself," she said. "If I had a big nose, I would want to fix it."

Her mother, who had implant surgery more than a decade ago, at age 31, would have helped pay for it.

"If that is what she really wants to do, I am not going to make a war over it," she said.

Breast augmentation has become the third-most frequent plastic surgery--after rhinoplasty and ear pinning--for girls not yet 19, according to a survey by the American Society of Plastic and Reconstructive Surgeons. In 1998, 1,840 girls under the age of 19 had breast implants, up 57% from 1996 and an 89% increase from 1992, with the greatest number of surgeries being performed in California, Texas and Florida. The actual number may be 50% higher, said experts, because the surgeons group surveys only its 5,000 members, not other physicians who do the procedure.

Teen surgeries remain a tiny fraction of all breast augmentations, but the procedure for adolescents stirs controversy, even among physicians. The nation's leading plastic surgeon associations have no specific age guidelines for patients receiving implants. Consequently, doctors must use their own judgment to balance benefits to a teen's ego against psychological, ethical and medical concerns.

A few doctors say they avoid providing cosmetic implants on anyone under 18. Other surgeons are more cautious with prospective teen patients than with older women.

"I have interviewed many 16-year-olds and turned away 95% of them," said Dr. Michael Niccole, a plastic surgeon with offices in Los Angeles and Orange counties. "Fifteen, 16 and 17 is a little young. You can call them mature, but 18 is more realistic."

Some critics question the wisdom of a teenager having this surgery because it tampers with a developing part of her body.

"Give a youngster time to mature and wrestle with these decisions," said Alan Solomon, a psychologist who practices in Torrance. "In the meantime, why not wear a push-up bra or falsies?"

Many teens with implants, however, voice no qualms about their decision.

"This is not social pressure," explained the Huntington Beach senior, who has worn padding and push-up bras. "It is honestly just me and how I feel about my body.

Adolescence has always been about learning to live with changing bodies, but today's media-driven images of beauty and women are unrelenting in their narrow portrayals of body types.

"I think society is driving this," said Dr. Paul Schnur, president of the surgeons society who teaches at the Mayo Clinic in Scottsdale, Ariz. "If you look at ads . . . you see the gorgeous, thin, big-breasted figure is the idol."

The media also are part of the drumbeat. Pop star Britney Spears, 17, received waves of recent publicity after reportedly getting implants. Affluence, too, plays a role in the growing trend, with some parents seeing implants as just another advantage for their daughters.

"Parents have extra capital to spend, so it is not unheard of for a 17- or 18-year-old to ask for and get breast augmentation for a graduation present," said Dr. Robert Joas, a San Diego anesthesiologist who works only with plastic surgeons. "There is enough affluence in Southern California that they can say you can have both the BMW and the breast implants."

Increasingly, daughters are being encouraged by mothers who are themselves veterans of the surgeon's knife.

"It is a natural progression," said Dr. Amy T. Bandy, a plastic surgeon who practices in the South Bay and Newport Beach. "Among the younger women I see, the ones who are the most comfortable have mothers who have had it done."

"Teens see it [surgery] is available and say, 'Why should I wait?' " said Dr. Robert Singer, a La Jolla plastic surgeon who is board chairman of the plastic surgeons organization.

Not every teen gets parental support. One 19-year-old Redondo Beach bank clerk fulfilled a yearning when she went from a B-cup to Ds--and alienated her family.

The clerk's mother is upset, her father has stopped talking to her and her sisters can't stop talking about it, she said.

"I didn't do this because I wanted attention," she said. And she laughed at her boyfriend when he suggested she shouldn't have surgery to please him.

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