Surgery for graduation?

A high school girl who is graduating soon may not want money or a car. She may have her sights on a completely different present: plastic surgery.

According to the American Society of Plastic Surgeons, more than 209,000 teenage girls underwent plastic surgery and cosmetic procedures in 2009.

The majority were noninvasive procedures, such as laser hair removal and skin resurfacing. But breast augmentation was one of the most popular surgeries and is increasingly requested by 18-year-old women.

Those numbers shouldn’t shock you. About half of the plastic surgeons surveyed said they’d treated high school age patients receiving gift certificates for their services.

It’s easy to see why this trend developed. Research shows that girls’ self-esteems are at their lowest during their early teen years. Although esteem tends to rise slightly by the end of high school, college women still rate low self-esteem as a serious problem in their lives. One study reported that 50 percent of high school girls and undergraduate women were dissatisfied with their bodies.

Such widespread unhappiness is linked to physical and emotional disorders, such as anorexia, bulimia, depression and self-harming. It encourages increased promiscuity and substance abuse. It also fosters poor choices in relationships; women with low self-esteem are more likely to select and stay with abusive or low-functioning partners.

Dr. Victoria Dickerson reports that young women today face extraordinary pressure, including the need to be thin and attractive. These women cannot possibly balance all the demands, and end up feeling like failures for not being good enough. This sense of not measuring up contributes to the pervasive lack of self-esteem that negatively impacts their life choices and satisfaction.

Pop culture is also obsessed with plastic surgery. Television shows like “The Swan,” “Extreme Makeover,” “Dr. 90210” and “Nip/Tuck” cash in on America’s fascination with the possibility of becoming someone new. What was once a hush-hush subject is now blatantly mainstream. If there’s something you don’t like about yourself just get it fixed.

But before parents pay for their teen’s plastic surgery, it’s wise to arm themselves with the facts. For example, there are no long-term studies on the safety of breast implants and liposuction performed on patients younger than 18. The risks, therefore, are unknown. And, although the FDA approved silicone gel breast implants for women ages 21 and older, and saline breast implants only for women 18 and older, there are no legal restrictions on the procedure. The American Society of Plastic Surgeons has an official position against breast augmentation for most teens younger than 18, but there is no enforcement.

Teens’ bodies are still maturing. Most women gain weight between the ages of 18 and 21, so their desires or needs for breast augmentation or liposuction may dramatically change.

Finally, young women expect that plastic surgery will improve their self-confidence. That may not be the case. One study found that body-image satisfaction improved after cosmetic surgery, but so did satisfaction among the control group. Perhaps body image improves as we get older, regardless of what we’ve changed along the way.

Steps to take if your child wants change

Is your teen pining for a new, surgically-induced look?

Have a heart-to-heart discussion with her:

• Assess why she wants to have the surgery. If her nose has been bothering her since grade school she may be a good candidate for rhinoplasty. If her goal is to look like Taylor Swift, she’s being unrealistic.

• Consider her physical age. Your high school age daughter probably has more growing to do. Encourage her to wait until she’s reached her adult size and shape before making permanent changes.

• Consider her emotional age.

Your daughter may dream about a shapelier figure. But she may be too immature to understand the risks, pain or side effects involved. A few more years will give her more perspective.

• Focus on your teen’s strengths. Direct your child away from over caring about her appearance. She has a lot to offer the world. Her looks are one small facet of who she is.

• Be a good role model. Parents instill values about physical appearance. If you are generally satisfied with your appearance, your comfort level rubs off on your kids.

• You have the final vote. Even if your child still wants plastic surgery, you have the ability to say no. She may go ahead and have the surgery when she’s an adult and pay for it on her own. Still, you have made a strong statement by not footing the bill.

Linda Lewis Griffith is a local marriage and family therapist. For information or to contact her visit lindalewisgriffith.com