Putting on a new face

Cosmetic surgery is attracting more and more young people eager to permanently alter their appearance.
Sunday, September 5, 2004 | 12:00 a.m. CDT; updated 12:00 a.m. CDT, Monday, July 21, 2008

It’s not just celebrities and reality-show participants. College-aged Columbians are doing it, too.

The “it” is cosmetic surgery, a trend that’s making headlines all over the United States.

The national statistics are compelling. Last year, nearly 8.3 million surgical and nonsurgical cosmetic procedures were performed, a 20 percent increase from 2002, as reported by the American Society for Aesthetic Plastic Surgery. Twenty-four percent of those procedures — more than 2 million — were done on people ages 19 to 34.

In 2003, there were more than 150,000 breast augmentations, 149,000 liposuctions and 83,000 rhinoplasties performed on college-aged Americans.

“Cosmetic-surgery procedures nationwide have increased overall for all age groups, and the national statistics support that,” said C. Lin Puckett, head of the Division of Plastic and Reconstructive Surgery at University Hospital.

Puckett said that while college-aged people might have had more procedures over the past few years, Columbia is like any other community.

“In Columbia, we are seeing more interest in patients aged 18 to 24 and an increase in cases as well,” Puckett said.

The increasing number of cosmetic procedures being done on college-aged women and men nationwide since 1997 is a significant trend, according to a spokesperson for the plastic-surgery association. In 2003, nearly 60,000 more surgeries were performed on patients in the 19-to-34 age group and more than 9,000 more were done on patients 18 and younger than in 2002.

Smoothing out the rough edges

Bumpy noses run in Michelle Chesnut’s family. The 18-year-old MU freshman’s aunts, uncles and mother all carry the same distinguishing trait. When she was 17, Chesnut was so unhappy with her nose that she and her mother consulted a plastic surgeon. Her rhinoplasty was performed in the summer before her senior year of high school.

“There were not a lot of risks involved, and my mom said if it would make me happy, I should do it,” Chesnut said. “My friends already knew that I hated my nose, but I didn’t want people who weren’t my friends to know.”

The post-surgery pain and healing were “not that bad,” she said.

“I do feel more confident,” she said. “I think appearance sometimes matters. I would do it again in a heartbeat. People have stuff done all the time.”

Chesnut said she is not considering any more cosmetic surgery.

“I’m more happy with myself now,” she said. “I do have other stuff about my body that I don’t like, but it’s nothing that bothers me so much that I would go and change it.”

Cosmetic procedures range from Botox injections to laser hair removal to face lifts. But Puckett said what brings many college-age patients to his office are the three most popular surgeries: breast implants, liposuction and rhinoplasty. He said he does more liposuction and breast implants in late spring and early summer, when patients are preparing for bathing suits and summer wardrobes. Most of his patients are white females, although more men and women from other ethnic and racial backgrounds are going under the knife.

“Cosmetic surgery is all about happiness,” Puckett said. “It helps people feel good about how they look.”

Puckett wouldn’t say how many procedures he has performed or how many cosmetic procedures are done annually at University Hospital. He said less than 10 percent of all surgical procedures, both cosmetic and reconstructive, are performed on college-aged patients. But he said he’s seen significant increases in the 18-to-24 age group.

Surgery for the young

State and local statistics regarding cosmetic surgeries are hard to find. Neither the Missouri Hospital Association nor the state Department of Health could provide numbers of procedures per year or types of surgeries by age because hospitals and surgical clinics are not required to report them.

Gregory Croll has practiced as a board-certified plastic and reconstructive surgeon in Columbia since 1991. Of the nearly 100 cosmetic procedures he does each year, 10 percent to 15 percent are for college-aged patients. Breast augmentation is the most common.

Croll said the cosmetic-surgery portion of his practice is small. He said he’s pleased with the local and national trends because it is good for business.

“I would like to see the trends increasing,” Croll said. “I can’t see why they shouldn’t, except for some economic impact like 9/11. Columbia is mirroring the national trend. It’s just a matter of the fact that we are subject to the same economic forces nationally. If conditions are looking bleak, procedures will decrease.”

Media coverage and “makeover” reality shows dealing with cosmetic surgery have helped drive the trends, Puckett said, especially in the 18-to-24 age group. Although this has led to a greater awareness of the power of plastic surgery and lessened its stigma, some surgeons don’t appreciate the way it is portrayed on television.

“A lot of the coverage is a bit of an embarrassment to plastic surgeons,” Puckett said. “The reality shows are putting forward a face we don’t particularly like, but they do bring attention to the concept of plastic surgery.”

While in New York for part of his plastic-surgery residency, Croll said, he witnessed dozens of rhinoplasties done on 16- and 17-year-old girls.

“I don’t see any patients less than 18 years old,” Croll said. “If I saw a 16-year-old that wanted any cosmetic surgery, I’d tell the parents that it is a lifelong thing to be responsible for. Patients should be making their decisions on their own, not the parents.”

Cosmetic surgery for young people is not all about rhinoplasties or breast implants.

At age 11, Jennifer Kowal, now 19, had had enough of what she calls her “elf ear.”

“In all my pictures, this one ear was always poking out of my hair,” Kowal said. “I was very self-conscious of it. I was always pulling my hair over to one side.”

With her parents’ permission, she decided to fix her ear surgically, a decision she doesn’t regret. She is not embarrassed about it, either

“My parents were fine with it,” said Kowal, anMU freshman. “But if I wanted my nose or boobs done, they would not have had the same reaction.”

Not every young person in Columbia who wants elective cosmetic surgery gets it. Puckett and Croll said they carefully assess whether the person’s physical defect can be corrected properly and if the patient understands all the risks involved. They only select those who are mature and have realistic expectations of what they will look like after surgery.

“If they think, ‘If I only had better-looking breasts again,’ it may not work for them,” Croll said.

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