When Is Teenage Plastic Surgery versus Cosmetic Surgery Okay? Reality versus Hype: A Systematic Review

The Utility of the Schnur Sliding Scale in Adolescent Patients

BACKGROUND

Although the Schnur Sliding Scale (SSS) was not intended to be used by third-party payors, it has become the national standard for coverage decisions regarding macromastia treatment in patients of all ages. Adolescents were neither included in the cohort that created the SSS nor represented in subsequent validation studies.

METHODS

In this prospective study, health-related quality of life surveys were administered to girls and young women 12 to 21 years of age before and after reduction mammaplasty to treat macromastia. The SSS was used preoperatively to estimate the amount of tissue to be resected. Before and after surgery, participants completed the Short Form-36, version 2 (SF-36); the Rosenberg Self-Esteem Scale (RSES); the Breast-Related Symptoms Questionnaire (BRSQ); and the Eating Attitudes Test-26. Demographic data were compared, and linear regressions were used to evaluate the effect of resection amounts meeting the SSS value on survey scores.

RESULTS

Resection amounts fell below the SSS for 39 patients and above the SSS for 255 patients. The 2 groups had no differences in mean age or body mass index. Both groups had significant postoperative survey score improvements on the RSES, BRSQ, and 7 of 8 SF-36 domains (all P < 0.05). The groups had comparable postoperative survey scores on the RSES, BRSQ, and 8 of 8 SF-36 domains (all P > 0.05).

CONCLUSIONS

Adolescents undergoing reduction mammaplasty above and below the SSS experienced comparable physical and psychosocial benefits. These findings underscore the need for third-party payors to broaden coverage for adolescent reduction mammaplasty, as the common coverage cutoff has no effect on overall postoperative benefit.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Risk, II.

A review of hair removal modalities in pediatric patients: Ethical and clinical considerations

Unwanted hair is a common concern among patients presenting to pediatric dermatology clinics, and parents and patients alike inquire about the safety of methods employed for elective removal. Various methods of hair removal exist with different levels of invasiveness and permanence, from simple mechanical depilation to light-based therapies. All methods of hair removal appear to be safe and generally well tolerated in children, and there are no age restrictions to any modality. In this review, we aim to address the available literature on the safety and efficacy of hair removal modalities in pediatric patients and propose guidance on how to manage requests for at-home and in-office therapies within an ethical framework.

The Effects of Cosmetic Procedures on the Youth

Cosmetic procedures involve the maintenance, restoration, or enhancement of one's physical appearance through surgical or medical techniques. Restorative or reconstructive procedures, on the other hand, are essential procedures that restore normal function or appearance to abnormal structures caused by trauma or infection. Cosmetic procedures are generally elective and may either be surgical or nonsurgical. Nonsurgical or minimally invasive cosmetic procedures include laser hair or tattoo removal, chemical peeling, micro-dermabrasion, and soft tissue augmentation with injectables. These procedures are fast-growing with more than a 50% increase globally over the last 5 years.

Selfie behavior and cosmetic surgery consideration in adolescents: the mediating roles of physical appearance comparisons and facial appearance concern

Selfie activity may contribute to the acceptance of cosmetic surgery in adolescents, although few empirical studies exist. Based on social comparison theory, this study examined the association between selfie behavior and cosmetic surgery consideration among Chinese adolescents and further tested the possible mediating roles of social comparison and facial appearance concern in this relationship. A sample of 537 adolescents (339 girls and 198 boys) were recruited voluntarily to complete questionnaires on selfie behavior, upward physical appearance comparison, facial appearance concern and cosmetic surgery consideration. Linear regression and mediation analyses were conducted. The results showed that selfie behavior predicted higher level of adolescents' cosmetic surgery consideration. Moreover, this relationship was sequentially mediated through upward physical appearance comparison and facial appearance concern. These findings expand the existent literature by suggesting that selfie behavior may trigger upward social comparison in adolescents, which in turn increase their acceptance of cosmetic surgery.

"I wanna look like the person in that picture": Linking selfies on social media to cosmetic surgery consideration based on the tripartite influence model

Based on the tripartite influence model, the present study linked investment in others' selfies on social media to facial dissatisfaction and cosmetic surgery consideration. We also tested the mediating role of appearance comparisons and general attractiveness internalization in these relationships. Additionally, potential gender differences in the proposed model were examined. A sample of 884 Chinese adolescents (mean age = 16.80 ± 0.92, ranging from 14 to 19 years old) completed self-reported measures of investment in others' selfies, appearance comparisons, general attractiveness internalization, facial dissatisfaction, and cosmetic surgery consideration. Results showed that investment in others' selfies was positively associated with facial dissatisfaction and cosmetic surgery consideration. Path analysis further revealed that investment in others' selfies was associated with appearance comparisons and general attractiveness internalization, which in turn were associated with facial dissatisfaction, and then facial dissatisfaction was related to cosmetic surgery consideration. Additionally, there were indirect associations between investment in others' selfies and cosmetic surgery consideration via general attractiveness internalization and facial dissatisfaction respectively, but not via appearance comparisons. No gender difference was found in the proposed model. Findings of the present study provide preliminary support for the tripartite influence model in the context of investment in others' selfies on social media and cosmetic surgery consideration and enrich the literature on body image and cosmetic surgery in the Chinese context.

Zoomers: videoconferencing, appearance concerns, and potential effects on adolescents

PURPOSE OF REVIEW

The cessation of in-person teaching to reduce the spread of COVID-19 dramatically increased the use of videoconferencing for home learning among adolescents.

RECENT FINDINGS

A consistent finding across studies assessing the relationship between videoconferencing and appearance concerns was that time spent focused on self-view was related to greater appearance concerns. Videoconferencing was associated with an increase in desire for cosmetic surgery and other nonsurgical treatments. Among those at risk of eating disorders, videoconferencing was associated with more appearance-management behaviours and less engagement in the video call. Research to date has been correlational and predominantly involved White, adult women in the USA and in Australia, leaving important gaps in our knowledge, especially around impacts on adolescents.

SUMMARY

Given their vulnerability to appearance concerns, we encourage practitioners to speak to adolescents about their use of videoconferencing and how they can migitate the potential negative impacts on body image.

RealSelf Social Media Analysis of Rhinoplasty Patient Reviews

BACKGROUND

Social media has become increasingly important for patients when deciding whether they should undergo rhinoplasty. The purpose of this study is to analyze patient satisfaction of rhinoplasty procedures through RealSelf social media reviews.

METHODS

We collected data from 583 rhinoplasty reviews published on the RealSelf portal. In posts dated between 2016 and 2020, we included those which were labeled as "Worth It" and "Not Worth It." Posts that were labeled as "Unsure" or were left unlabeled were excluded from the study. In addition, posts not including the cost of their rhinoplasty were excluded. Taking into account patient demographics and cost of the procedure, we analyzed reasons for choosing to undergo surgery, reasons for choosing surgeons, and reasons for liking or disliking their procedure.

RESULTS

Of the 583 reviews analyzed, most (45.4%) were categorized from the 18-24 years age group and there was an overall 93.8% satisfaction rate. While there was no statistically significant difference in the cost of rhinoplasty surgeries between "Worth It" and "Not Worth It" groups, the average cost of recorded rhinoplasties was US$ 8043 with a standard deviation ± $3296. According to our analysis, younger patients aged 18-24 years relied more on social media to choose their surgeons and desired a more natural appearance to their nose while older ones preferred compatible physician personalities and increased self-esteem for rhinoplasty.

CONCLUSION

This study offers a unique perspective into the distinguishing characteristics of different age groups and the values they place in pursuing rhinoplasty, choosing their surgeons, and why they like/dislike their surgical outcomes.

Body Talk on Social Networking Sites and Cosmetic Surgery Consideration Among Chinese Young Adults: A Serial Mediation Model Based on Objectification Theory

People’s interest in cosmetic surgery has increased in recent years. Drawing from objectification theory, in the present study, we examined the associations of body talk on social networking sites (SNS), body surveillance, and body shame with cosmetic surgery consideration. In particular, we examined the mediating roles of body surveillance and body shame in the relationship between SNS body talk and cosmetic surgery consideration. We also examined potential gender differences in the serial mediation model. Male and female college students in China ( N = 309) completed questionnaires regarding SNS body talk, body surveillance, body shame, and cosmetic surgery consideration. Results showed that SNS body talk, body surveillance, and body shame were positively associated with cosmetic surgery consideration. Body surveillance and body shame mediated the association between SNS body talk and cosmetic surgery consideration both separately and sequentially. Gender did not moderate any of the relations in the serial mediation model. Findings of this study provide new insight into the relationship between SNS use and cosmetic surgery and highlight facets of objectification as potential targets for prevention and intervention regarding appearance concerns.

Current Orthognathic Practice in India: Do We Need to Change?

The last decade or so has seen paradigm shifts in the various aspects of orthognathic surgery. A lot of these changes are to do with digitalization of the orthodontic-surgical workflow, optimization of surgery-first protocols, virtual surgical planning-based 3D printing solutions and changing patient-health-care dynamics. The aim of this article is to provide evidence-based recommendations that are both practical and economically viable for the current orthognathic practice in India.