Barb: Teenage plastic surgery is on the rise. More and more adolescence are opting to go under the knife over the summer, right before they return to school, and apparently rhinoplasty is by far the most popular procedure for back to schoolers, followed by otoplasty, the procedure to change the shape, position, or size of the ears. Now, some teens are getting into things like Botox and fillers, and that’s not something that every single cosmetic surgeon will do on teenagers.
Barb: Our favorite, and one of Canada’s top cosmetic surgeons, founder of Spa Medica, is Dr. Steven Mulholland. He joins us now. Hi, Dr. Mulholland.
Dr. Mulholland: Barb, good evening. How are you?
Barb: I’m good. Thanks a lot for doing this. How was your summer? We haven’t spoken to you?
Dr. Mulholland: Oh, it was a lot of fun. Camping and hiking and working, and I can honestly say no back to school crazy teenage rush for cosmetic surgery.
Barb: Okay. So it doesn’t happen? It’s not a thing?
Dr. Mulholland: This seems to be this kind of article pops up every couple of years. It could be popular collections from an individual physician. Often it will pop up from Miami, New York, London, that kind of thing. But in general, most board certified plastic surgeons would be very cautious about doing cosmetic plastic surgery on any teenager, certainly school age, which means by definition they’re 16 or 17. Rule number one, wait until the craniofacial skeleton, the bones and the cartilage, has achieved skeletal maturity, and that isn’t until usually 17 or 18. You wouldn’t want to change the shape of a nose if it was still going to grow.
Dr. Mulholland: Having said that, there are certainly children that are born with what would be clearly congenital or developmental abnormality, the absence of a part like an ear, or the clearly out of the range of norm parts such as eyes and ears and noses that doesn’t match the normative, and then that’s why we have a hospital for sick children where the child is analyzed, the family is counseled, and there is restorative surgery before that child would form some sort of self-image. But it’s tough enough to be teenagers. You have your own kids, and counsel them how to approach life responsibly without getting caught up in self-image surgery or self-image procedures like Botox and fillers.
Dr. Mulholland: So, unless you’re truly … Have an abnormal reconstructive need, a cosmetic balancing to get ready for your high school photos would generally be frowned upon, and we should encourage our kids to develop their brains and their minds and the consciousness and their hearts, but not their thirst to be Kylie Jenner.
Barb: Yeah, well, I think that’s a good point because we all want our kids to have friends and feel confident, and you want them to be the best them, but you don’t want them to feel like they have to change their appearance in order to conform to society, make themselves happier, get people to like them more.
Dr. Mulholland: I think that’s right. And kids nowadays have so much more pressure than we had in the 60s and the 70s. In the 60s and 70s, we didn’t have the same access to the kind of abnormal or let’s say trendsetting influencer behavior that young people do today on Instagram and other social media challenges, and there is a tendency towards young and extreme looks. But these are all … The Kardashians, the Jenners, there’s are all women in their early-20s to mid-20s that are trendsetting, not teenagers in grade 11 or 12. I think it’s philosophically wrong and I think that we’re really teaching our children the wrong values, that it’s all about your appearance, when really it’s usually your appearance might enhance your life, but you gotta have a brain to start a job and foundation. And that’s what we should be working on.
Barb: You’ve talked about people, let’s say under the age of 18, that have things that may be … I don’t know. It’s not the norm when it comes to certain things, and one of those, and I think that can be very, very hard on the self-esteem of young men, would be gynecomastia. The extra breast tissue.
Dr. Mulholland: Mm-hmm (affirmative). Mm-hmm (affirmative).
Barb: And breast reduction in men is also a very commonly performed “back to school” procedure. Have you seen young men looking to have that done?
Dr. Mulholland: So gynecomastia is one of those things such as extreme, outstanding ears or an absence of a female breast that doesn’t develop, or some breathing obstruction with a terribly overgrown septum in the nose. These things are then … On reconstructive … They’re on the reconstructive spectrum, and young men who have abnormal hormonal imbalances between estrogen and androgens can develop male breast tissue and that is a real dilemma and a reconstructive concern, because it can really traumatize a boy for the rest of his life. And that is covered by the [inaudible 00:05:26] Health Insurance Plan and the hospitals that do pediatric surgery, young adolescent surgery, such as Hospital for Children, East General, North York, and any other pediatric center in Canada. That kind of thing is covered.
Dr. Mulholland: So I’m not talking about that. I’m talking about someone who is relatively normal and has a little irritation in a proportion or the breasts aren’t quite big enough, or the nose is slightly too big, but still considered relatively normative. That would be cosmetic plastic surgery, and I think in general most plastic surgeons would frown on that as something to put off until someone is of more voting age or adult temperament and has a chance to live life and evaluate what really matters, and what’s important.
Barb: I think we’ve talked before about the ages getting younger and younger for certain procedures.
Dr. Mulholland: Mm-hmm (affirmative).
Barb: And there’s a belief among young people that Botox can prevent aging. And when I think about young people, and I’m even saying in their 20s getting Botox or fillers, can that actually affect the way they are going to age if they overdo it?
Dr. Mulholland: Well, the unfortunate thing for the reality of growing old naturally in your younger years is that if you are a daughter or a son of a mother or father that’s extremely animated and has strong number 11s, the frown lines, or crow’s feet, or worry lines, or you come from a thin family and you have deflation or absent lips that you inherited from your mother and from her mother, then indeed if you use Botox at a young age, late 20s, early 30s when you start to form creases from extremely animated, expressive faces, you will not form a line, you will stop those lines and wrinkles in their tracks.
Dr. Mulholland: So unfortunately, that is true, or fortunately. And I think we just need to caution young people not to get terribly obsessed with the first line they see. That’s completely normal. But again, these young kids, millennials that are faced with extremely competitive job situations, they’re often living in their parent’s basement playing Fortnight and video games, and it’s tough to get them out of a basement and getting a job, sometimes, requires looking your best, feeling your best, and as I said, I think we talked about on your show, the average age for Botox has gone down 10 years in the last 10 years from 41 to 31. So clearly that’s their trend, and now a 31-year-old young woman or man chooses to get Botox because they don’t like frown lines is one thing. Doing a rhinoplasty on a 15 or 16-year-old is another.
Barb: Yeah, for sure. Absolutely. And not putting them in the same category at all. Dr. Steven Mulholland, thank you very much for this.
Dr. Mulholland: As always.
Barb: Talk to you soon.
Dr. Mulholland: Good to talk to you. Thank you.
Barb: He is the founder of Spa Medica and one of Canada’s top cosmetic surgeons.