The age factor

All patients must be screened for realistic expectations, but assessing young patients takes extra care, said Dr. Leroy Young, a 25-year plastic surgeon in St. Louis and a spokesman for the American Society of Plastic Surgeons.

"For young people who want to have plastic surgery, they need to be aware of the risks and the long-term complications," Young explained. "Therein lies the dilemma. Usually at that age, they don't have the depth of experience."

ASPS recorded a 48 percent increase in total cosmetic procedures in people 18 and younger in 2003 from '02.

Rhinoplasty (nose job) and otoplasty (reducing ear size) are among the top surgeries, while chemical peels and microdermabrasion are popular nonsurgical procedures.

But it's the breast implant numbers that alarm some.

ASAPS indicates 11,326 augmentation procedures were done on women 18 and younger last year, a three-fold increase from 2002.

The Food and Drug Administration has approved saline breast implants for women 18 and older, though younger women can get them with parental consent, said Diana Zuckerman, president of the National Research Center for Women & Families in Washington, D.C. Zuckerman, who has a doctorate in psychology and did post-graduate training in epidemiology, is a well-known critic of implant safety.

"We get letters every day ... from women with breast implants," she said. "We hear from other women with plastic surgery problems and other problems as well, but nothing compares to breast implants."

"We're not opposed to all plastic surgery," she continued. "We're ... very concerned about the broader issue of how our image of perfection of body and face have changed."

Zuckerman's concern extends to all women, but she's especially worried about young women with young bodies that will likely gain weight between 18 and 22.

"I think that's very important that these girls are not done growing. ... Five, 10, 15 pounds will usually add a little cleavage. Maybe not a lot, but some, and for a lot of women, it's enough."

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