DEAN GLASSMAN MD

Dean Glassman, a plastic surgeon in Jacksonville, sees it all the time: a 15- or 16-year-old comes in for a consult grasping a picture of Britney Spears or some other celebrity that she wants to look like.

The parents? They’re sometimes just along for the ride, and it’s the girl who’s needling to go under the knife.

“I see them as young as 13 or 14, and I try to put them off and put them off,” he said. “As a rule, 18 is kind of my minimum.”

Glassman’s patients are just some of many girls in Jacksonville and across the country putting their bodies in the hands of plastic surgeons to fix imperfections and mold their flaws into something they perceive as more beautiful.

According to the American Society of Aesthetic Plastic Surgery, there were 203,308 procedures performed in 2009 on those 18 and under in the United States, compared to 145,094 in 2000. In all age groups, 91 percent of cosmetic procedures were performed on females, reports the American Society of Plastic Surgeons.

Plastic surgery is nothing new. Many women for years elected to have a nip here, a tuck there. While local figures weren’t available, there’s been an increase nationally in the past five years of plastic surgery among “The Hills”-watching and high school-age demographic, the ASAPS reports.

It’s the beauty ideal that some girls try to achieve and the desire to resemble celebrities that worries Lori Osachy, a psychotherapist who runs the Body Image Counseling Center in Jacksonville. She said the pressure on young women to meet a model look gives girls the idea that their worth is valued on outward appearances, and the quest for perfection is pushing girls more and more into the waiting rooms of plastic surgery offices.

“Teenage brains are very impulsive, and to make a decision based on impulse and severe pressure from the media and society to look a certain way — it’s not a good time in life to make a permanent decision,” she said.

She said encouraging girls to set boundaries on who they’re friends with and being proud of differences could dissuade their desire for cosmetic surgery, and starting plastic surgery procedures at a young age could start a cycle of a constant need for plastic surgery or manifest into body dysmorphic disorder.

Glassman said the most appropriate surgery for the under-18 age group, whether it’s fixing a little bump or giving a completely new look, is nose reshaping, because the nose stops growing usually in the mid-teens. He said in general, he won’t perform breast augmentation on girls younger than 18, and if someone is coming in for liposuction, he’ll be more conservative.

“It’s kind of a contouring thing to get to look a little better,” he said. “I wouldn’t do the same liposuction on a child or teenager that I would do in an adult. I would do a light [liposuction].”

In its 2009 report, the ASPS reported the top five procedures for teens ages

13-19 in order of popularity: nose reshaping, breast reduction in boys, breast augmentation, ear pinning (otoplasty) and liposuction.

One woman who elected to have a breast augmentation at a young age is Jessica. She asked the Times-Union not to publish her full name because she didn’t want to be stigmatized over her decision to have plastic surgery.

For about $3,500, the 19-year-old Jacksonville resident went from an A-cup breast size to “double Ds.” It bought her confidence, attention and quite a few chest stares, she said.

She would page through women’s magazines and see women with perfect figures, which she said was one of the reasons she wanted the surgery.

“If you look in every magazine, you see girls — girls who have nice bodies, and, I don’t know, I have a boyfriend, and I didn’t want him to look at other girls. I wanted him to look at me,” she said.

Some doctors in Jacksonville opt to steer clear of the teen set completely unless they are correcting a birth defect or deformity, regardless of the cosmetic procedure, said C. Cayce Rumsey III, a plastic surgeon who opened Ponte Vedra Plastic Surgery in 1993 and completes about 300 surgeries a year.

Rumsey said excluding nose reshaping, breast reduction and ear pinning, which he deems are appropriate for girls 16 and older, plastic surgery among young women isn’t always the best choice for the patient. During consultations, he’ll urge many of his younger patients to wait, think it over, and come back if they still want to do it at 18.

There are exceptions, even for more moderate doctors like Rumsey. One of his patients, Samantha, who asked that her last name not be published to avoid revealing private medical information, was 17 when she had her breast surgery. She was a full cup size bigger in her right breast, so she had a mastectomy on the larger breast, and Rumsey inserted implants on both sides.

She’s 19 now and prefers the scars of surgery to the size difference, she said, adding that she got her surgery during junior year, when trips to the beach with friends became part of her regular routine, and the size difference in her breasts triggered insecurities.

“I don’t believe in something that’s strictly cosmetic at that age,” she said. “But I also believe that it shouldn’t be such an uncomfortable point, the insecurity.”

The ASAPS’ report, “Teens and Plastic Surgery,” provides a breakdown for the reasons those under 18 elected to have breast augmentation. The report states 40 percent of breast augmentations were for cosmetic breast enlargement, 24 percent for severe asymmetry and the remaining 36 percent for a combination of other congenital disorders.

There is no formal position by the ASPS on plastic surgery for teens, but in a briefing statement, it does advise parents to “evaluate the teenager’s physical and emotional maturity and believes that individual cases merit careful evaluation under the guidance of a plastic surgeon.”

In its briefing paper on plastic surgery in teens, the society said plastic surgery can reverse social withdrawal.

The report also said, however, that although plastic surgery has great benefits, it also carries some risks, as with any surgery.

They are risks that a number of women, teens or adults, are apparently willing to overlook: Earlier this year , a study by RealSelf.com found 82 percent of women ages 18 to 44 and 80 percent ages 45 to 54 said they would get cosmetic treatments themselves if money weren’t an issue. The top-sought surgeries in those age groups were tummy tuck and liposuction.

tracy.jones@jacksonville.com, (904) 359-4272